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Self-mutilation

(Self-injury; Self-harm)

Definition

Self-mutilation or self-injury is any form of self-harm inflicted on your body without the intent to commit suicide.

Causes    TOP

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

Brain
Self-mutilation is often associated with psychiatric disorders that may be caused by chemical imbalances in the brain.
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Self-mutilation is more common in females and adolescents. Other factors that may increase your chances of self-mutilation:

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

Symptoms    TOP

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:

Diagnosis    TOP

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    TOP

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    TOP

Medications used include:

  • Antidepressants
  • Antipsychotics
  • Mood regulators
  • Anticonvulsants

Prevention    TOP

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

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_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Self_Injury_In_Adolescents_73.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.
Last reviewed December 2017 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 12/20/2014

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