394966381

Definition of Self Injury
Self-injury (SI) or self-harm (SH) is deliberate injury inflicted by a person upon their own body without suicidal intent. Some scholars use more technical definitions related to specific aspects of this behaviour. These acts may be aimed at relieving otherwise unbearable emotions, sensations of unreality and numbness. The illness is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as a symptom of borderline personality disorder and depressive disorders. It is sometimes associated with mental illness, a history of trauma and abuse including emotional abuse, sexual abuse, eating disorders, or mental traits such as low self-esteem or perfectionism, but a statistical analysis is difficult, as many self-injurers conceal their injuries.
Self harmers are often mistaken as suicidal, but in the majority of cases this is inaccurate. Non-fatal self-harm is common in young people worldwide and due to this prevalance the term self-harm is increasingly used to denote any non-fatal acts of deliberate self-harm, irrespective of the intention.
There are a number of different treatments available for self-injurers which concentrate on either treating the underlying causes or on treating the behaviour itself. When self-injury is associated with depression, antidepressant drugs and treatments may be effective. Alternative approaches involve avoidance techniques, which focus on keeping the self-injurer occupied with other activities, or replacing the act of self-harm with safer methods that do not lead to permanent damage.
Self-injury (SI), also referred to as self-harm (SH), self-inflicted violence (SIV) or self-injurious behaviour (SIB), refers to a spectrum of behaviours where demonstrable injury is self-inflicted. The term self-mutilation is also sometimes used, although this phrase evokes connotations that some find worrisome, inaccurate, or offensive. Self-inflicted wounds is a specific term associated with soldiers to describe non-lethal injuries inflicted in order to obtain early dismissal from combat. This differs from the common definition of self-injury, as damage is inflicted for a specific secondary purpose. A broader definition of self-injury might also include those who inflict harm on their bodies by means of disordered eating.
A common belief regarding self-injury is that it is an attention-seeking behaviour; however, in most cases, this is inaccurate. Many self-injurers are very self-conscious of their wounds and scars and feel guilty about their behaviour leading them to go to great lengths to conceal their behaviour from others. They may offer alternative explanations for their injuries, or conceal their scars with clothing. Self-injury in such individuals is not associated with suicidal or para-suicidal behaviour. The person who self-injures is not usually seeking to end his or her own life; it has been suggested instead that he or she is using self-injury as a coping mechanism to relieve emotional pain or discomfort. Studies of individuals with developmental disabilities (such as mental retardation) have shown self-injury being dependent on environmental factors such as obtaining attention or escape from demands. Though this is not always the case, some individuals suffer from disassociation and they harbor a desire to feel real and/or to fit in to society's rules. A common form of self-injury involves making cuts in the skin of the arms, legs, abdomen, inner thighs, etc. However, the number of self-injury methods are only limited by an individual's creativity and include, but are not limited to, compulsive skin picking (dermatillomania), hair pulling (trichotillomania), burning, stabbing, poisoning, alcohol abuse and forms of self harm related to anorexia and bulimia. The locations of self-injury are often areas of the body that are easily hidden and concealed from the detection of others As well as defining self-harm in terms of the act of damaging one's own body, it may be more accurate to define self-harm in terms of the intent, and the emotional distress that the person is attempting to deal with. Neither the DSM-IV-TR nor the ICD-10 provide diagnostic criteria for self-injury. It is often seen as only a symptom of an underlying disorder, though many people who self-injure would like this to be addressed.
Risk Factors
Although some people who self-injure do not suffer from any forms of recognised mental illness, many people experiencing various forms of mental ill-health do have a higher risk of self-injury. The key areas of illness which exhibit an increased risk include depression, phobias, and conduct disorders. Substance abuse is also considered a risk factor. as are some personal characteristics such as poor problem solving skills and impulsivity. Emotionally invalidating environments where parents punish children for expressing sadness or hurt can attribute to a lack of trust in oneself and difficulty experiencing intense emotions. Abuse during childhood is accepted as a primary social factor, as is bereavement, and troubled parental or partner relationships. Factors such as war, poverty, and unemployment may also contribute. In addition, some individuals with pervasive developmental disabilities such as autism engage in self-injury, although whether this is a form of self-stimulation or for the purpose of harming one's self is a matter of debate.
Treatment
There is considerable uncertainty about which forms of psychosocial and physical treatments of patients who harm themselves are most effective and as such further clinical studies are required. Psychiatric and personality disorders are common in individuals who self-harm and as a result self-injury may be an indicator of depression and/or other psychological problems. Many people who self-harm suffer from moderate or severe clinical depression and therefore treatment with antidepressant drugs may often be effective in treating these patients. Cognitive Behavioural Therapy may also be used (where the resources are available) to assist those with axis 1 diagnoses, such as depression, schizophrenia, and bipolar disorder. Dialectical behavioural therapy (DBT) can be very successful for those individuals exhibiting a personality disorder, and could potentially be used for those with other mental illnesses who exhibit self-injurious behaviour. Diagnosis and treatment of the causes of self-harm is thought by many to be the best approach to treating self-injury. But in some cases, particularly in clients with a personality disorder, this is not very effective, so more clinicians are starting to take a DBT approach in order to reduce the behaviour itself. People who rely on habitual self-injury are sometimes psychiatrically hospitalised, based on their stability, and their ability and especially their willingness to get help.
In individuals with developmental disabilities, occurrence of self-injury is often demonstrated to be related to its effects on the environment, such as obtaining attention or desired materials or escaping demands. As developmentally disabled individuals often have communication or social deficits, self-injury may be their way of obtaining these things which they are otherwise unable to obtain in a socially appropriate way (such as by asking). One approach for treating self-injury thus is to teach an alternative, appropriate response which obtains the same result as the self-injury.
Raise and Support
SI Awareness