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Self-mutilation
all information

Self-mutilation

(Self-injury; Self-harm)

En Español (Spanish Version)

Definition

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.

Causes

Self-mutilation is a severe impulse control disorder that is often associated with other psychiatric disorders. These include:

Brain—Psychological Organ

Brain

Self-mutilation is often associated with psychiatric disorders that may be caused by chemical imbalances in the brain.

© 2008 Nucleus Medical Art, Inc.

It can also be associated with neurologic or metabolic disorders such as:

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for self-mutilation include:

  • Childhood sexual, physical, or emotional abuse
  • Violence or other abusive relationships in childhood home
  • Post-traumatic stress disorder
  • Incarceration
  • Sex: female
  • Age: adolescence
  • Mental retardation
  • Autism
  • Certain metabolic disorders

Symptoms

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
  • Amputation
  • Castration
  • Suicide

Diagnosis

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

Treatment

Treatment usually includes medical and psychological treatment, and medications.

Medical Treatment

A doctor will assess whether care needs to be provided immediately to prevent further harm due to ingestion, wound, or other bodily harm.

Psychosocial Assessment

A psychosocial assessment may be administered to assess a person’s mental capacity, level of distress, and presence of mental illness.

Psychologic Treatment

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 interventions.

Medications

Medications used include:

  • Antidepressants
  • Antipsychotics
  • Mood regulators
  • Anticonvulsants

Prevention

The best preventative measure is to seek professional help as soon as possible for depression, trauma, emotional problems, or other disorders that may lead to self-mutilation.

RESOURCES:

American Academy of Child and Adolescent Psychiatry
http://www.aacap.org/

Bristol Crises Service for Women
http://www.users.zetnet.co.uk/BCSW/

The International Child and Youth Care Network
http://www.cyc-net.org/

CANADIAN RESOURCES:

AboutKidsHealth
http://www.aboutkidshealth.ca/

Canadian Mental Health Association
http://www.cmha.ca/

Canadian Organization for Rare Disorders
http://www.cord.ca/

References:

Bristol Crisis Service for Women website. Available at: http://www.users.zetnet.co.uk/BCSW/ .

Contagion of deliberate self-harm among adolescent inpatients. J Am Acad Child Adolesc Psychiatry . 1998 Feb.

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/CRDWeb/ShowRecord.asp?View=Full&ID=12007008022.

Diagnostic and Statistical Manual of Mental Disorder . 4th ed. 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.

Slee N, Garnefski N, van der Leeden R, et al. Cognitive-behavioral intervention for self-harm: randomized controlled trial. Br J Psychiatry . 2008;192(3):202-211. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18310581?dopt=Abstract .



Last reviewed May 2008 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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