| Risk Factors
Self-mutilation or self-injury is any form of self-harm inflicted on your body without the intent to commit suicide.
Self-mutilation may be caused by associated psychological problems. Self-mutilation may be done to release emotional pain, anger, or
anxiety. It may also be done to rebel against authority, flirt with risk-taking, or feel in control. In some cases, the behavior is outside your emotional control and related to a neurological or metabolic disorder.
Self-mutilation is often associated with psychiatric disorders that may be caused by chemical imbalances in the brain.
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Self-mutilation is more common in females and adolescents. Other factors that may increase your chance of self-mutilation include:
It can also be associated with neurologic or metabolic disorders such as:
The symptoms of self-mutilation vary. The most common symptoms include:
- Cutting of skin with a sharp object
- Skin carving or burning
- Self-punching or scratching
- Needle sticking
- Head banging
- Eye pressing
- Finger, lips, or arm biting
- Pulling out one's hair
- Picking at one's skin
Certain behavioral symptoms can be signs of self-multilation. These may include:
- Wearing long sleeves or pants, even in hot weather
- Claiming to have frequent accidents
- Relationship difficulties
- Behavioral and emotional difficulties
Rarely, in very severe cases, self-mutilation can include:
Self-mutilation can be difficult to diagnose. People who self-mutilate often feel guilty and ashamed about their behavior. They may try to hide it. Physical harm caused by self-mutilation may be the first sign noticed during an exam. To be diagnosed, symptoms should meet the following criteria:
- Excess thinking about physically harming oneself
- Inability to resist harming oneself, resulting in tissue damage
- Increased tension before and a sense of relief after self-injury
- Having no suicidal intent in the self-mutilation
To make an accurate diagnosis, the psychologist or psychiatrist will assess other conditions, such as personality or mood disorders, and whether there is suicidal intent. A psychosocial assessment may also be given to assess a person’s mental capacity, level of distress, and presence of mental illness.
Treatment usually includes medical and psychological treatment, as well as medications.
A doctor will assess whether care needs to be provided right away to
prevent further injury.
Psychologic treatment may be done either one-to-one or in a group setting. It is usually aimed at finding and treating the underlying emotional difficulty,
trauma, or disorder. It may also include
cognitive behavioral therapy.
Medications used include:
- Mood regulators
The best prevention is to get help as soon as possible for depression, trauma, emotional problems, or other disorders that may lead to self-mutilation.
Self-harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. National Institute for Health and Clinical Excellence website. Available at:
Updated July 2004. Accessed November 11, 2014.
Self-injury in adolescents. American Academy of Child & Adolescent Psychiatry website.
Updated July 2013. Accessed November 11, 2014.
Slee N, Garnefski N, van der Leeden R, Arensman E, Spinhoven P. Cognitive-behavioural intervention for self-harm: randomized controlled trial.
Br J Psychiatry. 2008;192(3):202-211.
Taiminin T, Kallio-Soukainen K, Nokso-Koivisto H, Kaljonen A, Helenius H.
Contagion of deliberate self-harm among adolescent inpatients.
J Am Acad Child Adolesc Psychiatry. 1998;37:(2)211-217.
Last reviewed December 2015 by Adrian Preda, MD
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