Self-injurious behavior: A clinical appraisal

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Abstract

A case series of self-injurious behavior (SIB) encountered in a General Hospital setting has been described. Limitations of current definition of SIB are explained. SIB is not a single clinical entity and it occurs in various psychiatric syndromes with wide range of psychopathology. Based on clinical criteria, a classification of SIB into three groups has been proposed viz 1) Mild and isolated form, 2) Moderately severe and repetitive form, and 3) Very severe and isolated form. Psychodynamic, cognitive and neurochemical explanations of SIB have been reviewed. Frustration, aggression and impulsivity appearing in helpless situation appear to be a common script across most of these models of explanations. Severity of injury seems to be determined by severity of psychopathology. Site of injury appear to have symbolic significance for a particular patient. Understanding some of these clinicopsychopathological issues helps in management of these cases.

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Most cited references 90

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Measurement of Deliberate Self-Harm: Preliminary Data on the Deliberate Self-Harm Inventory

Kim L. Gratz (2001)

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Self-mutilation, examined in samples of the general population, clinical groups, and self-identified self-mutilators, was reported by 4% of the general and 21% of the clinical sample, and was equally prevalent among males and females. Results suggest that such behavior is used to decrease dissociation, emotional distress, and posttraumatic symptoms. Childhood sexual abuse was associated with self-mutilation in both clinical and nonclinical samples.

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The deliberate self-harm syndrome.

Jillian M. Pattison, J Kahan (1983)

Recent research has differentiated several distinct classes of self-destructive behavior. This paper describes the clinical characteristics of one class, the deliberate self-harm syndrome. Analysis of 56 published case reports of self-harm revealed a typical pattern of onset in late adolescence, multiple recurrent episodes, low lethality, harm deliberately inflicted upon the body, and extension of the behavior over many years. Since the clinical characteristics of the deliberate self-harm syndrome differ substantially from those of other classes of self-destructive behavior, the authors propose that DSM-IV classify deliberate self-harm as a separate diagnostic syndrome.

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Author and article information

Journal

Journal ID (nlm-ta): Indian J Psychiatry

Journal ID (publisher-id): IJP

Title: Indian Journal of Psychiatry

Publisher: Medknow Publications (India )

ISSN (Print): 0019-5545

ISSN (Electronic): 1998-3794

Publication date (Print): Oct-Dec 2008

Volume: 50

Issue: 4

Pages: 288-297

Affiliations

Department of Psychiatry, JJM Medical College, Davangere, Karnataka - 577 004, India

Author notes

Correspondence: Dr. K. Nagaraja Rao, Department of Psychiatry, J. J. M. Medical College, Davangere - 577 004, Karnataka, India. Email: drknrao_dvg@ 123456yahoo.co.in

Article

Publisher ID: IJP-50-288

DOI: 10.4103/0019-5545.44754

PMC ID: 2755147

PubMed ID: 19823617

SO-VID: 98f9e4fb-17c1-428d-ab90-f7f41be1e57e

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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