The Significance of Aggression and Impulsivity for Self-mutilative Behavior

Abstract

Self-mutilative behavior (SMB) is presented as a specific form of inwardly directed aggressiveness which is thought to be associated with problems of impulse control. Conceptual problems concerning impulsivity and impulsive aggression are discussed. Among different forms of dyscontrolled behavior, SMB is of special heuristic interest because of distinction can be made between patients committing impulsive and those committing premeditated self-harming actions. Psychometric and biological measures of impulsivity and aggressiveness were assessed in self-mutilators in comparison to depressives and normal probands. Self-mutilators were differentiated into two subgroups, those with an impulsive (ISMB) and those with a premeditated (PSMB) form of SMB, and depressives were also differentiated into two subgroups, those with a history of suicide attempts and those without. Only patients with ISMB (and depressives with a history of suicide attempts) showed an enduring tendency towards dyscontrolled patterns of behavior and cognition; therefore, SMB cannot be generally regarded as an indicator of high impulsivity or an impulse control disorder. Measures of impulsivity and aggressiveness did not behave analogically to each other and aggressive or autoaggressive modes of behavior should not be generally used as an index of impulsivity. A reduction of serotonergic activity, proved by a blunted prolactin response to D-fenfluramine, was found in all patient-groups in comparison to normal probands. Prolactin response after D-fenfluramine challenge turned out to be most blunted among self-mutilators with ISMB and among depressives with a history of suicide attempts.

Should Nonsuicidal Self-Injury Be a Putative Obsessive-Compulsive-Related Condition? A Critical Appraisal

“…However, researchers have investigated the associations among impulsivity, obsessive compulsive characteristics, and NSSI. Increased impulsivity is associated with history of NSSI (Bennum & Phil, 1983; Herpertz, Sass, & Favazza, 1997), as well as severity of skin picking behaviors (Hayes et al, 2009). Further, individuals with a history of NSSI can be distinguished from non-injurers by the tendency to make rash decisions when faced with negative emotions and by difficulty delaying action in order to plan (Glenn & Klonsky, 2010).…”

Are self-injurers impulsive?: Results from two behavioral laboratory studies

“…Clinical experience and some prior research suggest that impulsiveness is an important correlate of NSSI (Herpertz et al, 1997; Herpertz et al, 1995; Simeon et al, 1992). Self-reported impulsiveness is correlated with the severity and frequency of NSSI (Simeon et al, 1992) and with the absence of forethought before engaging in NSSI (Herpertz et al, 1995).…”

“…Self-reported impulsiveness is correlated with the severity and frequency of NSSI (Simeon et al, 1992) and with the absence of forethought before engaging in NSSI (Herpertz et al, 1995). Moreover, the strong link between NSSI and suicide attempts (Joiner, 2006; Nock et al, 2006) combined with research on the role of impulsiveness in suicide attempts (e.g., Dougherty et al, 2004; Jollant et al, 2005) suggest that measures of impulsiveness may provide insight into NSSI.…”

Impulsivity and self-harm in adolescence: a systematic review

“…Impulsivity has been identified as a risk factor for self-harm behaviour [17, 18]. A recent review and meta-analysis across clinical and non-clinical mixed age populations [19] found greater levels of self-reported impulsivity in those who engaged in non-suicidal self-injury compared to those who did not.…”