Self-injury is the act of deliberately
destroying body tissue, at times to change a way of feeling.
Self-injury is seen differently by groups and cultures within society.
This appears to have become more popular lately, especially in
adolescents. The causes and severity of self-injury can vary.
Some forms may include: carving,
marking, picking, and pulling skin
and hair, burning/abrasions,
head banging, bruising,
excessive body piercing
Some adolescents may self-mutilate to take risks, rebel, reject their
parents' values, state their individuality or merely be accepted.
Others, however, may injure themselves out of desperation or anger to
seek attention, to show their hopelessness and worthlessness, or
because they have suicidal thoughts. These children may suffer from
serious psychiatric problems such as depression, psychosis,
Posttraumatic Stress Disorder (PTSD) and Bipolar Disorder.
Additionally, some adolescents who engage in self-injury may develop
Borderline Personality Disorder as adults. Some young children may
resort to self-injurious acts from time to time but often grow out of
it. Children with mental retardation and/or autism may also show these
behaviors which may persist into adulthood. Children who have been
abused or abandoned may self-mutilate.
Why do adolescents self-injure?
Adolescents who have difficulty talking about their feelings may
show their emotional tension, physical discomfort, pain and low
self-esteem with self-injurious behaviors. Although they may feel like
the "steam" in the "pressure cooker" has been released following the
act of hurting themselves, teenagers may instead feel hurt, anger,
fear and hate. The effects of peer pressure and contagion can also
influence adolescents to injure themselves. Even though fads come and
go, most of the wounds on the adolescents' skin will be permanent.
Occasionally, teenagers may hide their scars, burns and bruises due to
feeling embarrassed, rejected or criticized about their deformities.
What can parents and teenagers do about self-injury?
Parents are encouraged to talk with their children about
respecting and valuing their bodies. Parents should also serve as role
models for their teenagers by not engaging in acts of self-harm. Some
helpful ways for adolescents to avoid hurting themselves include
accept reality and find ways to make the present moment more
identify feelings and talk them out rather than acting on them.
distract themselves from feelings of self-harm (for example, counting
to ten, waiting 15 minutes, saying "NO!" or "STOP!," practicing
breathing exercises, journaling, drawing, thinking about positive
images, using ice and rubber bands, etc.)
stop, think, and evaluate the pros and cons of self-injury.
soothe themselves in a positive, non-injurious, way.
practice positive stress management.
develop better social skills.
Evaluation by a mental health professional may assist in identifying
and treating the underlying causes of self-injury. Feelings of wanting
to die or kill themselves are reasons for adolescents to seek
professional care emergently. A child and adolescent psychiatrist can
also diagnose and treat the serious psychiatric disorders that may
accompany self-injurious behavior.
The American Academy of Child and
Adolescent Psychiatry (AACAP) represents over 6900 child and
adolescent psychiatrists who are physicians with at least five years
of additional training beyond medical school in general (adult) and
child and adolescent psychiatry. The
Facts for Families© series is developed and distributed by
the American Academy of Child and Adolescent Psychiatry (AACAP). Facts
sheets may be reproduced for personal or educational use without
written permission, but cannot be included in material presented for
As related to mental
retardation or autism:
Self-injurious behavior (SIB),
displayed by individuals with autism and mental retardation, involves
the occurrence of behavior that results in physical injury to one’s
own body. Common forms of SIB include, but are not limited to
head-hitting, head-banging, and hand-biting. In the most severe cases,
SIB can result in retinal detachment, blindness, broken bones,
bleeding, or death. SIB is displayed by 10% to 15% of individuals with
autism and mental retardation. These estimates are higher among
individuals living in institutions and among those with greater
cognitive impairments. SIB is also associated with certain genetic
disorders, such as Lesch-Nyhan and Rett Syndromes.
Individuals may engage in SIB for a variety reasons. In some
cases, SIB may occur because it results in favorable outcomes, such as
attention from caregivers or the termination of academic or
instructional demands. SIB may also be biologically based. For
example, some research has suggested that SIB may result in the
release of chemicals in the brain that produce pleasurable effects.
Although there is considerable evidence to support of all of these
explanations, current thought indicates that SIB is a highly complex,
heterogeneous phenomenon that is often attributable to a combination
of factors. Visit
http://www.kennedykrieger.org/kki/kki_diag.jsp?pid=1074 for more
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