Deliberate Self-Harm
(1-31-07)

"Deliberate self-harm is defined as the intentional injuring of one's own body without apparent suicidal intent." (Klonsky, Oltmanns, & Turkheimer, 2003, p. 1501).

superficial-moderate self-mutilation
self-injurious behavior
parasuicide
self-wounding

In their review of previous literature, Klonsky et al. note that reports that approximately 4% of the general population & 14% of a college population report a history of deliberate self-harm (Klonsky, Oltmanns, & Turkheimer, 2003, p. 1501).

Klonsky evaluated 1,986 Air Force recruits, 62% male. Mean age was 20 years (s.d. 5), mean IQ was 104, 99% were high school graduates. 65% were Caucasian, 17% were African American, 4% were Hispanic, 3% Asian, 1% Native American, 10% listed race as "other." 25 recruits who reported a history of a suicide attempt were excluded.

The Klonsky et al. study results found that approximately 4% of a nonclinical population had harmed themselves at least once, and that less than 1% had chronically engaged in self-harm. The prevalence rates were similar for males and females.

Individuals with a history of self-harm had more traits of the borderline, schizotypal, dependent, and avoidant personality disorders as measured by both self- and peer reports.

Their data suggested that, "self-harmers are better characterized as anxious than depressed." (p. 1506).

This DSH is probably different from the self-injurious behavior seen in individuals with autism and other developmental disabilities.

Breau, Camfield, Symons, Bodfish, McKay, Finley, & McGrath (2003) looked at 101 nonverbal children between 3 and 18 years of age. They concluded that data did not support the hypothesis of less sensitivity to pain. Concluded that children with SIB have pain reactions similar to those without SIB. Their data suggested there might be two forms of SIB: 1) one form is less frequent, associated with chronic pain, and involves SIB directed near the site of pain. 2) less related to chronic pain and is directed at the head and hands.

DSH may play a role in affect regulation (especially in clients with "borderline" characteristics and adolescents); this self-injurious behavior is often carried out in secret and the individual attempts to avoid detection; DSH may also be use as an operant to effect the individual's social environment ("manipulative" self-injurious behavior, also seen in individuals with "borderline" characteristics). Occasionally DSH may be seen in individuals with antisocial characteristics in an attempt to established the legitimacy of a "suicide attempt"; this usually represents deliberate malingering in an effort to avoid or minimize responsibility for prior behavior or actions.