Self-mutilation or self-injury is any form of self-harm inflicted on your body without the intent to commit suicide. Self-mutilation is a compulsive act that may be performed to release emotional pain, anger, or anxiety]]> ; to rebel against authority; to flirt with risk-taking; or to feel in control. In some cases, the behavior is outside your emotional control and related to a neurological or metabolic disorder.
The behavior is not considered socially appropriate. It is also not part of a religious custom or a form of art.
Self-mutilation is a severe impulse control disorder that is often associated with other psychiatric disorders, such as:
- Borderline personality disorder]]> (most common)
- Substance abuse ( ]]>alcoholism]]> or ]]>drug abuse]]> )
- Eating disorders ( ]]>anorexia]]> or ]]>bulimia]]> )
- ]]>Antisocial personality disorders]]>
- ]]>Post-traumatic stress disorder]]>
It can also be associated with neurologic or metabolic disorders such as:
These factors increase your chance of developing this condition. Tell your doctor if you have any of these risk factors:
The symptoms of self-mutilation vary. The most common symptoms include:
- Cutting of skin with a sharp object (most common)
- Skin carving or burning
- Self-punching or scratching
- Needle sticking
- Head banging
- Eye pressing
- Finger, lips, or arm biting
- Pulling out one's hair
- Picking at one's skin
Rarely, in very severe cases, self-mutilation can include:
- Broken bones]]>
Self-mutilation can be difficult to diagnose. People who self-mutilate often feel guilty and ashamed about their behavior and may try to hide it. A doctor may first see the physical harm caused by self-mutilation. To be diagnosed, symptoms should meet the following criteria:
- Preoccupation with physically harming oneself
- Inability to resist self-injurious behavior resulting in tissue damage
- Increased tension before and a sense of relief after self-injury
- Having no suicidal intent in the self-mutilation
To make an accurate diagnosis, the psychologist or psychiatrist will assess other conditions, like personality or mood disorders, and whether there is suicidal intent.
Treatment usually includes medical and psychological treatment, as well as medications.
A doctor will assess whether care needs to be provided immediately to prevent further harm due to ingestion, wound, or other bodily harm.
This assessment may be administered to assess a person’s mental capacity, level of distress, and presence of mental illness.
Psychologic treatment may be done either one-to-one or in a group setting. It is usually aimed at finding and treating the underlying emotional difficulty, trauma]]> , or disorder. It may also include ]]>cognitive behavioral therapy]]> .
Medications used include:
- Mood regulators
American Psychological Association
Mental Health America
Canadian Mental Health Center
Canadian Psychological Association
Bristol Crisis Service for Women website. Available at: http://www.users.zetnet.co.uk/BCSW/ .
Database of abstracts of reviews and effects (DARE). Psychosocial interventions following self harm: systematic review of their efficacy in preventing suicide. Centre for Reviews and Dissemination website. Available at: http://www.crd.york.ac.uk .
Diagnostic and Statistical Manual of Mental Disorder . 4th ed. Washington, DC: American Psychiatric Association; 2000.
The International Child and Youth Care Network website. Available at: http://www.cyc-net.org/ .
Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. National Institute for Health and Clinical Excellence website. Available at: http://www.nice.org.uk/nicemedia/pdf/CG016NICEguideline.pdf .
Self-injury in adolescents. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/publications/factsfam/73.htm . Accessed July 2003.
Self-injury/cutting. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/self-injury/DS00775 . Updated August 2008. Accessed February 23, 2009.
Slee N, Garnefski N, van der Leeden R, et al. Cognitive-behavioral intervention for self-harm: randomized controlled trial. Br J Psychiatry . 2008;192:202-211.
Taiminin T, Kallio-Soukainen K, Nokso-Koivisto H, Kaljonen A, Helenius H. Contagion of deliberate self-harm among adolescent inpatients. J Am Acad Child Adolesc Psychiatry . 1998;37:211.
Last reviewed January 2009 by ]]>Theodor B. Rais, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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