Self-mutilation or self-injury is any form of self-harm inflicted on your body without the intent to commit suicide. Self-mutilation may be done to release emotional pain, anger, or anxiety ; to rebel against authority; to flirt with risk-taking; or to feel in control. In some cases, the behavior is outside your emotional control and related to a neurological or metabolic disorder.
Self-mutilation may be caused by associated psychological problems.
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Factor that increase your chance of developing this condition include:
It can also be associated with neurologic or metabolic disorders such as:
The symptoms of self-mutilation vary. The most common symptoms include:
Rarely, in very severe cases, self-mutilation can include:
Self-mutilation can be difficult to diagnose. People who self-mutilate often feel guilty and ashamed about their behavior. They may try to hide it. Physical harm caused by self-mutilation may be the first sign noticed during an exam. To be diagnosed, symptoms should meet the following criteria:
To make an accurate diagnosis, the psychologist or psychiatrist will assess other conditions, like personality or mood disorders, and whether there is suicidal intent. A psychosocial assessment may also be given to assess a person’s mental capacity, level of distress, and presence of mental illness.
Treatment usually includes medical and psychological treatment, as well as medications.
A doctor will assess whether care needs to be provided right away to treat or prevent further injury.
Psychologic treatment may be done either one-to-one or in a group setting. It is usually aimed at finding and treating the underlying emotional difficulty, trauma , or disorder. It may also include cognitive behavioral therapy .
Medications used include:
American Psychological Association
Mental Health America
Canadian Mental Health Center
Canadian Psychological Association
National Collaborating Centre for Mental Health. Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. National Institute for Health and Clinical Excellence website. Available at: http://www.nice.org.uk/nicemedia/pdf/CG016NICEguideline.pdf . Updated July 2004. Accessed July 29, 2013.
Self-injury in adolescents. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Self_Injury_In_Adolescents_73.aspx . Updated December 2009. Accessed July 29, 2013.
Slee N, Garnefski N, van der Leeden R, et al. Cognitive-behavioral intervention for self-harm: randomized controlled trial. Br J Psychiatry . 2008;192:202-211.
Taiminin T, Kallio-Soukainen K, Nokso-Koivisto H, Kaljonen A, Helenius H. Contagion of deliberate self-harm among adolescent inpatients. J Am Acad Child Adolesc Psychiatry . 1998;37:211.
Last reviewed July 2013 by Rimas Lukas, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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