The Identification and Management of Self-Mutilating Patients in Primary Care

A 65‐year‐old Woman With Self‐injurious Behavior: A Case Report

“…Serotonergic medications are proposed to reduce impulsivity 12 . As in this case, pharmacotherapy may be effective in the treatment of comorbid psychiatric disorders such as depression 1 …”

“…To the Editor: Self‐injurious behavior (SIB) is deliberate destruction of body tissues without conscious suicidal intent 1 . SIB typically appears in adolescence and is commonly associated with borderline personality disorder (BPD) 2 .…”

Client Non-Suicidal Self-Injurious Behavior: Considerations for Clinical Supervisors

“…Nock and Prinstein (2004) proposed that self-injury serves as a form of autonomie reinforcement (i.e., emotion regulation) and/or is a means of obtaining social reinforcement (e.g., gaining support from others). Other research has indicated that people may engage in self-injury in order to diminish dissociation, depersonalization, and derealization and to relieve feelings of emptiness and numbness, while others report that they gain a sense of control over their lives and their emotions secondary to self-injuring (Dallam, 1997;Simeon & Favazza, 2001).…”

“…For clients who do disclose self-injury, supervisors should direct trainees to ask detailed questions regarding frequency, duration, and typical methods of harm. Because of possible dangerousness of self-injury, clinicians must demonstrate a capacity to recognize the presence of high risk factors such as using unsanitary methods of cutting, sharing blades, cutting while intoxicated (Dallam, 1997;DiClemente, Ponton, & Hartley, 1991). Supervisees must also display an ability to communicate these risk factors to the client.…”

“…A supervisee must be prepared to ask difficult questions and to probe for follow-up responses when clients disclose self-injury. Supervisees might be instructed on the dangers of using rusty blades or sharing blades with other people who self-injure so as to prevent disease transmission (Dallam, 1997;DiClemente et al, 1991).…”