Self‐injury: A research review for the practitioner

Abstract

Non-suicidal self-injury is the intentional destruction of body tissue without suicidal intent and for purposes not socially sanctioned. In this practice-friendly review, the authors summarize the empirical research on who self-injures, why people self-injure, and what treatments have demonstrated effectiveness. Self-injury is more common in adolescents and young adults as compared to adults. Common forms include cutting, severe scratching, burning, and banging or hitting; most individuals who self-injure have used more than one method. Although diagnostically heterogeneous, self-injurers typically exhibit two prominent characteristics: negative emotionality and self-derogation. Self-injury is most often performed to temporarily alleviate intense negative emotions, but may also serve to express self-directed anger or disgust, influence or seek help from others, end periods of dissociation or depersonalization, and help resist suicidal thoughts. Psychotherapies that emphasize emotion regulation, functional assessment, and problem solving appear to be most effective in treating self-injury.

Boy Crisis? Sex Differences in Self-Injurious Behaviors and the Effects of Gender Role Conflicts Among College Students in China

“…Self-injurious and suicidal behaviors, however, reported not only strong similarities but also very small differences. Research has indicated that a large number of self-injurers admit that they have also been suicidal (Firestone & Seiden, 1990;Klonsky & Muehlenkamp, 2007;Muehlenkamp & Gutierrez, 2004;Nock et al, 2006). Despite the similarities, research has also revealed obvious differences between the two types of behavior in terms of embodiment, traits, and willingness (Klonsky & Muehlenkamp, 2007;Messer & Fremouw, 2008;Muehlenkamp, 2005).…”

“…Research has indicated that a large number of self-injurers admit that they have also been suicidal (Firestone & Seiden, 1990;Klonsky & Muehlenkamp, 2007;Muehlenkamp & Gutierrez, 2004;Nock et al, 2006). Despite the similarities, research has also revealed obvious differences between the two types of behavior in terms of embodiment, traits, and willingness (Klonsky & Muehlenkamp, 2007;Messer & Fremouw, 2008;Muehlenkamp, 2005). The relationship between gender role conflicts and suicidal behaviors and the relationship between suicidal and self-injurious behaviors signify that the gender patterns in self-injurious behaviors among Chinese adolescents as a boy crisis are probably associated with gender role conflicts.…”

Lifetime prevalence of non-suicidal self-injury in patients with eating disorders: a systematic review and meta-analysis

“…Non-suicidal self-injury (NSSI) is the intentional destruction of body tissue without suicidal intent and for purposes not socially sanctioned (Klonsky & Muehlenkamp, 2007). Examples of NSSI include 'impulsive' acts (preceded by increasing tension, and followed by pleasure, gratification, or relief), such as skin cutting/burning, and 'compulsive' acts (repetitive, seemingly driven, but non-functional motor behaviour acts), such as hair pulling or skin picking (Favazza & Simeon, 1995;Klonsky & Muehlenkamp, 2007).…”

“…NSSI is reported to occur in 4-18% of the general population, in 14-68% of individuals with anorexia nervosa (AN), and in 25-55% of individuals with bulimia nervosa (BN), while 54-61% of people with selfinjurious behaviours report current or past ED (Sansone & Levitt, 2002;Jacobson & Gould, 2007;Klonsky & Muehlenkamp, 2007;Kostro et al 2014). The observed link is set against a background of established similarities in epidemiology, underlying mechanisms, and correlates between the two psychopathologies.…”

Non-suicidal self-injury: clinical presentation, assessment and management

“…In terms of methods, females are more likely to use cutting, whereas males are more likely to use self-hitting or burning (Andover, Primack, Gibb, & Pepper, 2010;Klonsky & Muehlenkamp, 2007).…”