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What Factors Influence Self-Injurious Behavior?

Non-suicidal self-injury is the act of someone intentionally hurting his or her body. In most cases, youths engage in self-injurious behaviors to cope with intense anger, emotional pain, and life frustrations. For youths, self-injurious behavior is also triggered by poor coping skills and difficulties in managing emotions (Ong & Thompson, 2019). Young people, especially teens, lack essential coping skills to handle psychological pain. Additionally, some have a hard time expressing, regulating, understanding emotions and feelings such as loneliness, rejection, panic, guilt, and anger leading to self-injurious behaviors.

Other risk factors that would lead youth to engage in self-injurious behaviors include alcohol and substance use, mental health issues, peer pressure, and traumatic life issues. Youths who have friends who self-injure could be persuaded to engage in the vice when they face problems. Life issues such as emotional, sexual, and physical abuse as well as questioning sexuality or personal identity, could trigger self-injurious behaviors among youths (Mayo Clinic, 2018). Mental health issues such as depression, personality, and post-traumatic stress disorder could increase the risk to self-injure (Richert et al., 2020). Although self-injurious behaviors could lead to a release of tension and a momentary sense of calm, the act is often accompanied by shame, guilt, and the return of painful emotions

Choose One Self-Injurious Behaviors

Self-injurious behaviors that an individual could engage in include self-harming, self-mutilation, and skin cutting. The key focus is self-mutilation, which encompasses self-injurious behaviors such as picking the skin, hair pulling, and excessive use of mind-altering substances such as drugs and alcohol. Self-mutilation also involves deliberately destructing or altering body tissue through actions such as burning or cutting oneself. 

Causative Factors for These Behaviors

According to Ong and Thompson (2019), the causative factors of self-mutilation include poor coping skills and difficulties dealing with life issues. The author notes individuals who self-mutilate have difficulties experiencing feelings of anger, anxiety, or sadness. As such, they self-mutilate by disfiguring or cutting their skin as a coping mechanism and as a way of dissociating from the immediate tension. Mayo Clinic (2018) also notes that individuals who self-mutilate are likely to have suffered emotional, sexual, or physical abuse from a person known to them, such as parents or family members. This triggers self-mutilation as an attempt to escape from painful or intolerable feelings linked to the trauma of abuse. 

According to Balázs et al. (2018), there are three distinct types of self-mutilation observed in various populations, superficial, major, and stereotypic self-mutilation. Superficial mutilation is common among people diagnosed with borderline and personality disorders, while stereotypic mutilation is linked to mentally ill individuals (Balázs et al., 2018). Major self-mutilation such as cutting the genitals or amputation of the limbs is associated with pathology, where a person is suffering from serious health issues. 

Evidence-Based Treatment Modalities

Treatment for self-injurious behaviors, particularly self-mutilation, requires physicians to provide patient-centered care because patients respond differently to various interventions. Before providing treatment, a physician should first diagnose the patient to determine the cause of the self-mutilation behaviors such as life issues, mental health disorders, or substance use. If the self-mutilation behavior is linked to mental health issues, a physician should provide psychotherapy treatments such as cognitive-behavioral, mindfulness-based, and dialectical-behavioral therapies to the patient. According to Andover et al. (2017), the psychotherapy treatment will assist the patient to regulate emotions better and manage distress. Furthermore, it will help boost the patient’s self-image, improve social skills, and enhance problem-solving skills. If self-mutilation is triggered by life issues such as emotional, physical, or sexual abuse, the patient is offered family and group therapy. Family therapy enables the individual to address any forms of abuse perpetrated against them by family members leading to forgiveness and better communication and support (Cottrell et al., 2018). Individuals with self-mutilation behaviors are offered medications such as mood stabilizers, antidepressants, anti-anxiety medication, and low-dose antipsychotics (Papathanasiou et al., 2015). These medications prevent the urge to self-harm. 

 

 

References

Andover, M. S., Schatten, H. T., Morris, B. W., Holman, C. S., & Miller, I. W. (2017). An intervention for nonsuicidal self-injury in young adults: A pilot randomized controlled trial. Journal of Consulting and Clinical Psychology, 85(6), 620.

Balázs, J., Győri, D., Horváth, L. O., Mészáros, G., & Szentiványi, D. (2018). Attention-deficit hyperactivity disorder and nonsuicidal self-injury in a clinical sample of adolescents: The role of comorbidities and gender. BMC Psychiatry, 18(1), 1-10.

Cottrell, D. J., Wright-Hughes, A., Collinson, M., Boston, P., Eisler, I., Fortune, S., ... & Farrin, A. J. (2018). Effectiveness of systemic family therapy versus treatment as usual for young people after self-harm: a pragmatic, phase 3, multicentre, randomised controlled trial. The Lancet Psychiatry, 5(3), 203-216.

Mayo Clinic. (2018, December 7). Self-injury/cutting - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950

Ong, E., & Thompson, C. (2019). The importance of coping and emotion regulation in the occurrence of suicidal behavior. Psychological Reports, 122(4), 1192-1210.

Papathanasiou, I. V., Tsaras, K., Neroliatsiou, A., & Roupa, A. (2015). Stress: Concepts, theoretical models and nursing interventions. American Journal of Nursing Science, 4(2-1), 45-50.

Richert, T., Anderberg, M., & Dahlberg, M. (2020). Mental health problems among young people in substance abuse treatment in Sweden. Substance Abuse Treatment, Prevention, and Policy, 15(1), 1-10.