Clinical correlates of self-mutilation in a sample of general psychiatric patients.

The aims of this study were to examine whether certain axis I disorders characterized by impulsive aggression were associated with self-mutilative behavior and to evaluate the clinical correlates of self-mutilation in a sample of general psychiatric outpatients. Two hundred fifty-six outpatients were administered diagnostic interviews for axis I and axis II disorders. In addition, questionnaires that measured self-mutilative acts within the last 3 months, dissociation, and childhood abuse were completed. This study found that axis I disorders of substance abuse, posttraumatic stress disorder, and intermittent explosive disorder were significantly related to self-mutilative behavior, independent of borderline personality disorder and antisocial personality disorder. Also, a higher level of dissociation was related to self-mutilation, controlling for borderline personality disorder and childhood abuse. Outpatients with certain axis I disorders and those who dissociate may represent a sizable group of patients who are at risk for self-mutilative behavior.

[1]  C. Zlotnick,et al.  Affect regulation and suicide attempts in adolescent inpatients. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[2]  J. Gunderson,et al.  Changes in Self‐Destructiveness of Borderline Patients in Psychotherapy A Prospective Follow‐Up , 1995, The Journal of nervous and mental disease.

[3]  S. Samuel,et al.  Self-cutting after rape. , 1989, The American journal of psychiatry.

[4]  L. Siever,et al.  Serotonergic function and self-injurious behavior in personality disorder patients , 1997, Psychiatry Research.

[5]  E. Shearin,et al.  Subtypes of self-injurious patients with borderline personality disorder. , 1993, The American journal of psychiatry.

[6]  Dorothy M. Bernstein,et al.  Images in Psychiatry , 1994 .

[7]  J. Guzder,et al.  Psychological Risk Factors for Dissociation and Self-Mutilation in Female Patients with Borderline Personality Disorder * , 1994, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[8]  M. Cloitre,et al.  Relationship of dissociation to self-mutilation and childhood abuse in borderline personality disorder. , 1995, The American journal of psychiatry.

[9]  S. Shearer,et al.  Dissociative phenomena in women with borderline personality disorder. , 1994, The American journal of psychiatry.

[10]  E. Pattison,et al.  Proposal for a distinctive diagnosis: the deliberate self-harm syndrome (DSH). , 1984, Suicide & life-threatening behavior.

[11]  B. Kolk,et al.  The psychobiology of posttraumatic stress disorder. , 1997, The Journal of clinical psychiatry.

[12]  J. Lacey,et al.  The impulsivist: a multi-impulsive personality disorder. , 1986, British Journal of Addiction.

[13]  E. Shearin,et al.  Self-injurious behavior and mood regulation in borderline patients. , 1997, Journal of personality disorders.

[14]  J. Lacey,et al.  Multiple Self-damaging Behaviour among Alcoholic Women , 1992, British Journal of Psychiatry.

[15]  E. Hollander,et al.  Neurobiology of impulsivity and the impulse control disorders. , 1993, The Journal of neuropsychiatry and clinical neurosciences.

[16]  C. Zlotnick,et al.  Validation of the structured interview for disorders of extreme stress. , 1997, Comprehensive psychiatry.

[17]  M. Thase,et al.  Fluoxetine treatment of patients with major depressive disorder who failed initial treatment with sertraline. , 1997, The Journal of clinical psychiatry.

[18]  A. Favazza,et al.  Female habitual self‐mutilators , 1989, Acta psychiatrica Scandinavica.

[19]  M. Linehan,et al.  Cognitive-behavioral treatment of chronically parasuicidal borderline patients. , 1991, Archives of general psychiatry.

[20]  C. Zlotnick,et al.  The relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self-mutilation. , 1996, Comprehensive psychiatry.

[21]  S. Shearer,et al.  Intent and lethality of suicide attempts among female borderline inpatients. , 1988, The American journal of psychiatry.

[22]  A R Favazza,et al.  Self-mutilation and eating disorders. , 1989, Suicide & life-threatening behavior.

[23]  G. Bach-y-Rita Habitual violence and self-mutilation. , 1974, The American journal of psychiatry.

[24]  J. C. Perry,et al.  Childhood origins of self-destructive behavior. , 1991, The American journal of psychiatry.

[25]  L. Konopka,et al.  Serotonin-induced increases in platelet cytosolic calcium concentration in depressed, schizophrenic, and substance abuse patients , 1995, Biological Psychiatry.

[26]  J. Krystal,et al.  Clinical Predictors of Self-Mutilation in Hospitalized Forensic Patients , 1994, The Journal of nervous and mental disease.

[27]  J Foote,et al.  Initial reliability and validity of a new retrospective measure of child abuse and neglect. , 1994, The American journal of psychiatry.

[28]  R. Rosenthal,et al.  Varieties of Pathological Self-mutilation. , 1990, Behavioural neurology.

[29]  M. Feldman The challenge of self-mutilation: a review. , 1988, Comprehensive psychiatry.