Definition
Self-mutilation or self-injury is any form of self-harm inflicted on your body without the intent to commit suicide.
Causes
Self-mutilation may be caused by associated psychological problems. Self-mutilation may be done to release emotional pain, anger, or anxiety . It may also be done to rebel against authority, flirt with risk-taking, or feel in control. In some cases, the behavior is outside your emotional control and related to a neurological or metabolic disorder.
| Brain—Psychological Organ |
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| Self-mutilation is often associated with psychiatric disorders that may be caused by chemical imbalances in the brain. |
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Risk Factors
Self-mutilation is more common in females and adolescents. Other factors that may increase your chances of self-mutilation:
- Childhood sexual, physical, or emotional abuse
- Violence or other abusive relationships in a child's home
- Being in prison
- Intellectual disability
- Psychiatric disorders such as:
- Certain metabolic disorders
- Alcohol use disorder or drug abuse
- Eating disorders, such as anorexia or bulimia
It can also be associated with neurologic or metabolic disorders such as:
Symptoms
The symptoms of self-mutilation vary. The most common symptoms include:
- Cutting of skin with a sharp object
- 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
Certain behavioral symptoms can be signs of self-multilation. These may include:
- Wearing long sleeves or pants, even in hot weather
- Claiming to have frequent accidents
- Relationship difficulties
- Behavioral and emotional difficulties
Rarely, in very severe cases, self-mutilation can include:
- Broken bones
- Amputation
- Castration
- Eye damage
- Suicide
Diagnosis
Self-mutilation can be difficult to diagnose. People who self-mutilate often feel guilty and ashamed about their behavior. They may try to hide it. Physical harm caused by self-mutilation may be the first sign noticed during an exam. To be diagnosed, symptoms should meet the following criteria:
- Excess thinking about physically harming oneself
- Inability to resist harming oneself, 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, such as personality or mood disorders, and whether there is suicidal intent. A psychosocial assessment may also be given to assess a person’s mental capacity, level of distress, and presence of mental illness.
Treatment
Treatment usually includes medical and psychological treatment, as well as medications.
Medical Treatment
A doctor will assess whether care needs to be provided right away to treat or prevent further injury.
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 therapy .
Medications
Medications used include:
- Antidepressants
- Antipsychotics
- Mood regulators
- Anticonvulsants
Prevention
The best prevention is to get help as soon as possible for depression, trauma, emotional problems, or other disorders that may lead to self-mutilation.
RESOURCES
American Psychological Association https://www.apa.org
Mental Health America http://www.mentalhealthamerica.net
CANADIAN RESOURCES
Canadian Psychiatric Association https://www.cpa-apc.org
Canadian Psychological Association https://cpa.ca
References
Self-harm in over 8s: Short-term management and prevention of recurrence. Clinical guideline (CG16). National Institute for Health and Clinical Excellence website. Available at: https://www.nice.org.uk/guidance/CG16. Updated July 2004.
Self-injury in adolescents. American Academy of Child & Adolescent Psychiatry website. Available at: https://www.aacap.org/AACAP/Families%5Fand%5FYouth/Facts%5Ffor%5FFamilies/Facts%5Ffor%5FFamilies%5FPages/Self%5FInjury%5FIn%5FAdolescents%5F73.aspx. Updated July 2013. Accessed January 31, 2018.
Slee N, Garnefski N, van der Leeden R, Arensman E, Spinhoven P. Cognitive-behavioural intervention for self-harm: randomized controlled trial. Br J Psychiatry. 2008;192(3):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:(2)211-217.
Revision Information
- Reviewer: EBSCO Medical Review Board Adrian Preda, MD
- Review Date: 11/2018
- Update Date: 12/20/2014