In the present study two broad hypotheses about the origins of self-mutilation in psychiatric patients were evaluated. The first hypothesis states that self-mutilation originates from child abuse and experiences of neglect and is connected to dissociation in later life. The second hypothesis views self-mutilation as the consequence of impulse control problems. To test these two hypotheses, data concerning traumatic childhood experiences and dissociative symptoms (hypothesis 1), as well as data concerning aggressiveness, obsessive-compulsiveness and sensation seeking (hypothesis 2) were collected in a sample of 54 psychiatric inpatients. Twenty-four out of 54 patients (44%) reported having engaged in self-mutilation. Mean age of onset of this behaviour was 23 years. Self-report measures of self-mutilators were more in line with the first than with the second hypothesis. That is, patients who engaged in self-mutilation reported more traumatic childhood experiences and dissociative symptoms than did control patients. The two groups did not differ in terms of aggressiveness, obsessive-compulsiveness, and sensation seeking. In line with earlier studies, the current results indicate that self-mutilating behaviour is linked to a history of abuse and neglect.

Objective The Community Assessment of Psychic Experiences has been widely translated and commonly used as a measure for psychotic experiences and psychosis proneness in clinical and research environments worldwide. This study aimed to establish the psychometric properties (reliability and validity) and factor structure of a Korean version of the Community Assessment of Psychic Experiences (K-CAPE) in the general population.Methods A total of 1,467 healthy participants completed K-CAPE and other psychiatric symptom-related scales (Paranoia scale, Patient Health Questionnaire-9, Dissociative Experiences Scale-II, and Oxford-Liverpool Inventory of Feelings and Experiences) via online survey. K-CAPE’s internal reliability was analyzed using Cronbach’s alpha coefficient. Confirmatory factor analysis (CFA) was performed to investigate whether the original three-factor model (positive, negative, and depressive) and other hypothesized multidimensional models (including positive and negative subfactors) were suitable for our data. Exploratory factor analysis (EFA) was conducted to explore better alternative factor solutions with a follow-up CFA. To assess convergent and discriminant validity, we examined correlations between KCAPE subscales with other established measures of psychiatric symptoms.Results K-CAPE showed good internal consistency in all original three subscales (all greater than α=0.827). The CFA demonstrated that the multidimensional models exhibited relatively better quality than the original three-dimensional model. Although the model fit indices did not reach their respective optimal thresholds, they were within an acceptable range. Results from the EFA indicated 3–5 factor solutions. In 3-factor solution, “negative-avolition” items were founded to be loaded more consistently with depressive items than with the negative dimension. In 4-factor solution, positive items were divided into two subfactors: “positive-bizarre experiences” and “positive-delusional thoughts,” while negative symptoms were separated into two distinct subfactors in 5-factor solution: “negative-avolition (expressive),” and “negative-social (experiential).” The correlation coefficients between K-CAPE subscales and corresponding measurements were significant (p<0.001), confirming the convergent and discriminant validity.Conclusion Our study provides evidence to support the reliability and validity of the K-CAPE and its use as a measure of psychotic symptoms in the Korean population. Although alternative factor structures did not improve the model fit, our EFA findings implicate the use of subfactors to investigate more specific domains of positive and negative symptoms. Given the heterogeneous nature of psychotic symptoms, this may be useful in capturing their different underlying mechanisms.

ResumenEn el presente estudio se valoraron dos hipótesis generales sobre los orígenes de la automu-tilación en los pacientes psiquiátricos. La primera afirma que la automutilación tiene su origen en el abuso infantil y las experiencias de abandono y está relacionada con disociación en momentos posteriores de la vida. La segunda ve la automutilación como consecuencia de problemas del control de impulsos. Para examinar estas dos hipótesis, se recogieron datos acerca de experiencias infantiles traumáticas y síntomas disociativos (hipótesis 1), así como datos acerca de la agresividad, la conducta obsesivo-compulsiva y la búsqueda de sensaciones (hipótesis 2) en una muestra de 54 pacientes psiquiátricos hospitalizados. Veinticuatro de 54 pacientes (44%) comunicaron haberse mutilado. La edad media de comienzo de este comportamiento era 23 años. Las medidas de autoinforme de los pacientes que se mutilaron estaban más de acuerdo con la primera hipótesis que con la segunda. Es decir, los pacientes que se mutilaron comunicaban más experiencias infantiles traumáticas y síntomas disociativos que los pacientes de control. Los dos grupos no diferían por lo que se refiere a la agresividad, la conducta obsesivo-compulsiva y la búsqueda de sensaciones. De acuerdo con estudios anteriores, los presentes resultados indican que el comportamiento de automutilación se relaciona con una historia de abuso y abandono.