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The psychological, psychiatric and psychophysiological correlates of self-mutilation

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Haines, J (1994) The psychological, psychiatric and psychophysiological correlates of self-mutilation. PhD thesis, University of Tasmania.

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Abstract

Type III self-mutilation is defined as deliberately inflicted and often
repetitive low lethality sell-injurious behaviour, of a socially unacceptable
nature, performed in the absence of conscious suicidal intent and at a tithe
of psychological crisis. It includes such behaviours as self-cutting, self-burning,
skin-abrading, self-hitting and wound excoriation. The behaviour is believed
to reflect severe psychopathology and alteration or extinction of the behaviour
is problematic.
This investigation examined aspects of self-mutilative behaviour in a
male incarcerated population. Comparisons were made with two control
groups: a group of male prisoners with no history of self-mutilation and a
normal control group with no history of self-mutilation or criminal
incarceration. Three studies were conducted. The first study examined those variables reported in the literature to be
concomitants of self-mutilative behaviour. As stated, self-mutilation is said
to reflect excessive psychopathology. However, incarceration also is associated
with elevated symptom levels. It was necessary to determine if a pattern of
psychopathology existed that effectively distinguished the self-mutilators
from non-mutilating prisoners as well as individuals with no history of
self-mutilation or incarceration.
A distinctive pattern of symptomatology emerged. Self-mutilators
evidenced a wide range of elevated scores on general measures of
psychological/psychiatric symptoms, particularly depression and hostility.
Aspects of hostility that distinguished self-mutilators from other groups included the urge to act out hostile feelings, critical feelings towards others,
paranoid feelings of hostility and guilt. Self-mutilators demonstrated
substantial problems with substance abuse, particularly alcohol. A pattern
of passive-aggressive, schizoid and avoidant personality styles distinguished
self-mutilators from other groups. Consideration also was made to some factors which may have led to
these elevated scores and have been associated with self-mutilation in the
literature. Generally, the family backgrounds of self-mutilators were
unremarkable. Although a history of sexual abuse did not differentiate the
groups, there was some evidence that the self-mutilators experienced more
severe physical punishment during childhood than control groups. The
patterns of these factors differed substantially from results reported in the
literature. It was concluded that the occurrence of self-mutilative behaviour
be viewed as the primary consideration in understanding the behaviour
with differing patterns of psychopathology being understood as secondary
and treated symptomatically. As a consequence of this conclusion, the
following question needed to be addressed. If self-mutilative behaviour is
not necessarily a symptom of a disorder, then what is it?
The second study was based on the notion that the act of self-mutilation
is an effective, although maladaptive, strategy for coping with stress. It was
hypothesised that self-mutilators would have deficient skills in coping and
problem-solving. These deficits would leave self-mutilators vulnerable to
the adoption of self-mutilative behaviour as a coping strategy.
Examination of the inherent resources which enable an individual to
cope adequately and effectively with stress demonstrated a depressed score for self-mutilators on the scale measuring self-worth, a positive approach to
others and a general optimism about life. In addition, assessment of the
strategies used to cope with real problems demonstrated that self-mutilators
engaged in more problem avoidance behaviours. Self-mutilators also
recorded less perceived control over problem-solving options. Consideration
also was given to a range of attitudes or beliefs that predispose an individual
to distress. Self-mutilators endorsed a range of irrational beliefs that indicated
they generally experienced feelings of little control over life events and a
desire to avoid problem situations. However, while these deficits existed for
this sample, many aspects of their coping and problem-solving repertoires
were adequate. The results suggested that there was a property of selfmutilation
that recommended its use to those who engaged in the behaviour.
The consistent theme in the literature suggested that this property was tension
reduction. There is much agreement in the literature with regard to the
consequences of the behaviour. Self-mutilation is used as a means of
alleviating unpleasant psychological states. In brief, the phenomenology of
an episode of self-cutting, for example, involves increasing tension and
distress as a result of a precipitating factor such as an adverse life event.
Negative affect escalates until a state of depersonalisation is experienced. At
this point the individual will engage in painless cutting. On the sight of
blood, repersonalisation occurs and tension is reduced. Clinical reports of
this process resulted in the development of the tension reduction model of
self-mutilation. The model postulates that self-mutilation operates as a
drive reduction mechanism. The reduction of tension following an act of self-mutilation is reinforcing, increasing the likelihood that when
experiencing a similar negative psychological state, the self-mutilator will
repeat the behaviour to gain relief.
The third study tested the tension reduction model of self-mutilation
to determine if the behaviour was being maintained by its reinforcing qualities.
Self-mutilators' psychophysiological and subjective responses during a
visualised self-mutilative act were investigated. Arousal to three imaged
control events (neutral, accidental injury and aggression) were examined for
differences between self-mutilating prisoner, prisoner control and normal
control groups. Imagery scripts were presented in four stages: scene setting,
approach, incident, and consequence. Results demonstrated a decrease in
psychophysiological and subjective response during imagery of the act of
self-mutilation. A lag between psychophysiological and psychological
response to the self-mutilative act was demonstrated. Patterns of response
elicited during self-mutilation imagery were markedly different to those
during control imagery. Results were consistent with reports indicating that
self-mutilative behaviour is maintained by the reinforcing tension reducing
qualities of the act. The implications of the results of this research to the
management of self-mutilative behaviour are discussed.

Item Type: Thesis (PhD)
Keywords: Self-mutilation, Self-mutilation
Copyright Holders: The Author
Copyright Information:

Copyright 1994 the Author - The University is continuing to endeavour to trace the copyright
owner(s) and in the meantime this item has been reproduced here in good faith. We
would be pleased to hear from the copyright owner(s).

Additional Information:

Thesis (Ph.D.)--University of Tasmania, 1995.

Date Deposited: 09 Dec 2014 00:00
Last Modified: 27 Mar 2017 23:39
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