Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-26T11:34:40.207Z Has data issue: false hasContentIssue false
  • English
  • Français

Self-mutilating behaviour of psychiatric inpatients

Published online by Cambridge University Press:  16 April 2020

H.L.I. Nijman ,
M. Dautzenberg ,
H.L.G.J. Merckelbach ,
P. Jung ,
I. Wessel  and
J. à Campo
H.L.I. Nijman
Affiliation:
Psychiatric Hospital Welterhof, Heerlen, P.O. Box 4436, 6401 CX Heerlen, The Netherlands Department of Psychology, Maastricht University Maastricht, The Netherlands
M. Dautzenberg
Affiliation:
Psychiatric Hospital Welterhof, Heerlen, P.O. Box 4436, 6401 CX Heerlen, The Netherlands
H.L.G.J. Merckelbach
Affiliation:
Department of Psychology, Maastricht University Maastricht, The Netherlands
P. Jung
Affiliation:
Psychiatric Hospital Welterhof, Heerlen, P.O. Box 4436, 6401 CX Heerlen, The Netherlands
I. Wessel
Affiliation:
Department of Psychology, Maastricht University Maastricht, The Netherlands
J. à Campo
Affiliation:
Psychiatric Hospital Welterhof, Heerlen, P.O. Box 4436, 6401 CX Heerlen, The Netherlands
Get access

Summary

In the present study two broad hypotheses about the origins of self-mutilation in psychiatric patients were evaluated. The first hypothesis states that self-mutilation originates from child abuse and experiences of neglect and is connected to dissociation in later life. The second hypothesis views self-mutilation as the consequence of impulse control problems. To test these two hypotheses, data concerning traumatic childhood experiences and dissociative symptoms (hypothesis 1), as well as data concerning aggressiveness, obsessive-compulsiveness and sensation seeking (hypothesis 2) were collected in a sample of 54 psychiatric inpatients. Twenty-four out of 54 patients (44%) reported having engaged in self-mutilation. Mean age of onset of this behaviour was 23 years. Self-report measures of self-mutilators were more in line with the first than with the second hypothesis. That is, patients who engaged in self-mutilation reported more traumatic childhood experiences and dissociative symptoms than did control patients. The two groups did not differ in terms of aggressiveness, obsessive-compulsiveness, and sensation seeking. In line with earlier studies, the current results indicate that self-mutilating behaviour is linked to a history of abuse and neglect.

Keywords

self-mutilationimpulsivitychildhood traumadissociation
Type
Original article
Information
European Psychiatry , Volume 14 , Issue 1 , March 1999 , pp. 4 - 10
Copyright
Copyright © Elsevier, Paris 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barstow, DG. Self-injury and self-mutilation. Nursing approaches. J Psychosoc Nurs 1995; 33 : 19–22.Google ScholarPubMed
Bernstein, DP. Childhood Trauma Questionnaire (53 item version) Scoring Form. New York: Mount Sinai School of Medicine; 1995.Google Scholar
Bernstein, DPAhluvalia, TPogge, DHandelsman, L. Validity of the childhood trauma questionnaire in an adolescent psychiatric population. J Am Acad Adol Psychiatry 1997; 36 : 340–348.10.1097/00004583-199703000-00012CrossRefGoogle Scholar
Bernstein, DPFink, LHandelsman, LFoote, JLovejoy, MWenzel, K. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry 1994; 151 : 1132–1136.Google ScholarPubMed
Bernstein, EMPutnam, FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis 1996; 174 : 727–735.CrossRefGoogle Scholar
Brodsky, BSCloitre, MDulit, RA. Relationship of dissociation to self-mutilation and childhood abuse in borderline personality disorder. Am J Psychiatry 1995; 152 : 1788–1792.Google ScholarPubMed
Chu, JADill, DL. Dissociative symptoms in relation to childhood physical and sexual abuse. Am J Psychiatry 1990; 147 : 887–892.Google ScholarPubMed
Darche, MA. Psychological factors differentiating self-mutilating and non-self-mutilating adolescent inpatient females. Psychiatr Hosp 1990; 21 : 31–35.Google Scholar
Dulit, RAFyer, MRLeon, ACBrodsky, BSFrances, AJ. Clinical correlates of self-mutilation in borderline personality disorder. Am J Psychiatry 1994; 151 : 1305–1311.Google ScholarPubMed
Favazza, AR. Why patients mutilate themselves. Hosp Comm Psychiatry 1989; 40 : 137–145.Google ScholarPubMed
Favazza, ARConterio, K. The plight of chronic self-mutilators. Comm Ment Health J 1988; 24 : 22–30.10.1007/BF00755050CrossRefGoogle ScholarPubMed
Favazza, ARosenthal, RJ. Diagnostic issues in self-mutilation. Hosp Comm Psychiatry 1993; 44 : 134–140.Google ScholarPubMed
Feij, JAZuilen, RW van. Handleiding Spanningsbe-hoefte Lijst, SBL (manual sensation seeking scale) Lisse: Swets & Zeitlinger; 1984Google Scholar
Hillbrand, M. Aggression against self and aggression against others in violent psychiatric patients. J Consult Clin Psychol 1995; 63 : 668–671.CrossRefGoogle ScholarPubMed
Jones, IHDaniels, BA. An ethological approach to self-injury. Br J Psychiatry 1996; 169 : 263–267.CrossRefGoogle ScholarPubMed
Konicki, PESchulz, SC. Rationale for clinical trials of opiate antagonists in treating patients with personality disorders and self-injurious behaviour. Psychopharm Bull 1989; 25 : 556–563.Google Scholar
Langbehn, DRPfohl, B. Clinical correlates of self-mutilation among psychiatric inpatients. Ann Clin Psychiatry 1993; 5 : 45–51.CrossRefGoogle ScholarPubMed
Lange, APahlich, ASarucco, MSmits, GDehghani, BHanewald, G. Psychometric characteristics and validity of the Dutch adaptation of the Buss-Durkee Hostility Inventory (the BDHI-D). Behav Res Ther 1995; 33 : 223–227.CrossRefGoogle Scholar
Lester, D. Physical abuse and physical punishment as precursors of suicidal behaviour. Stress Medicine 1991; 7 : 255–256.10.1002/smi.2460070408CrossRefGoogle Scholar
Linnoila, VMIVirkunnen, M. Aggression, suicidality, and serotonin. J Clin Psychiatry 1992; 53 suppl 10 46–51.Google ScholarPubMed
Merckelbach, HMuris, PRassin, E. Fantasy proneness and cognitive failures as correlates of dissociative experiences. <ISSUE> Pers Individ Diff; in press.CrossRefPers+Individ+Diff;+in+press.>Google Scholar
Merckelbach, HMuris, P. The causal link between self-reported trauma and dissociation: a critical review. <ISSUE> Submitted for publication; 1998.Google Scholar
Nijman, HMuris, PMerckelbach, HPalmstierna, TWistedt, BVos, Aet al. The Staff Observation Aggression Scale-Revised (SOAS-R). <ISSUE> Aggr Behav; in press.3.0.CO;2-C>CrossRefAggr+Behav;+in+press.>Google Scholar
Rachman, SHodgson, RJ. Obsessions and Compulsions Englewood Cliffs: Prentice-Hall Inc; 1980Google Scholar
Shearer, SL. Phenomenology of self-injury among inpatient women with borderline personality disorder. J Nerv Ment Dis 1994; 182 : 524–526.Google ScholarPubMed
Simeon, DStanley, BFrances, AMann, JJWinchel, RStanley, M. Self-mutilation in personality disorders: psychological and biological correlates. Am J Psychiatry 1992; 149 : 221–226.Google ScholarPubMed
Soloff, PHLis, JAKelly, TCornelius, JUlrich, R. Self-mutilation and suicidal behaviour in borderline personality disorder. J Pers Disorders 1994; 8 : 257–267.CrossRefGoogle Scholar
Soutwick, SMKrystal, JHBremner, JD Ca, Morgan, NicoLaou, ALNagu, LM. Noradrenergic and serotonergic function in posttraumatic stress disorder. Arch Gen Psychiatry 1997; 54 : 749–758.CrossRefGoogle Scholar
Suyemoto, KL. The functions of self-mutilation. Clin Psychol Rev 1998; 18 : 531–554.CrossRefGoogle ScholarPubMed
Verkes, RJKerhof, GABeld, EHengeveld, MWvanKempen, GMJ. Suicidality, circadian activity rhythms and platelet serotonergic measures in patients with recurrent suicidal behaviour. Acta Psychiatr Scand 1996; 93 : 27–34.CrossRefGoogle ScholarPubMed
Winchel, RMStanley, M. Self-injurious behaviour: a review of the behaviour and biology of self-mutilation. Am J Psychiatry 1991; 148 : 306–315.Google ScholarPubMed
Zlotnick, CShea, MTPearlstein, TSimpson, ECostello, EBegin, A. The relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self-mutilation. Compr Psychiatry 1996; 37 : 12–16.CrossRefGoogle ScholarPubMed
Zuckerman, M. Sensation seeking: beyond the optimal level of arousal Hillsdale: Erlbaum; 1979Google Scholar
Submit a response

Comments

No Comments have been published for this article.