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Self Injury Behaviors (SI) - Warning Signs
Press Release July, 2011

Self-Injury (SI) also called self-mutilation, self-harm or self-abuse is a behavior defined as the deliberate, repetitive, impulsive, non-lethal harming of one ’s self.

Self-injury includes:
• cutting
• scratching
• picking scabs or interfering with wound healing
• burning
• punching self or objects
• infecting oneself
• inserting objects in body openings
• bruising or breaking bones
• some forms of hair-pulling, as well as other various forms of bodily harm

SI behaviors are symptoms of mental health problems that can be treated.

SI Warning Signs
Warning signs that someone is injuring themselves include: unexplained frequent injury including cuts and burns, wearing long pants and sleeves in warm weather, low self-esteem, and difficulty handling feelings, relationship problems, and poor functioning at work, school or home.

SI Incidence & Onset

Experts estimate the incidence of habitual self-injurers is nearly 1% of the population, with a higher proportion of females than males. The typical onset of self-harming acts is at puberty. The behaviors often last 5-10 years but can persist much longer without appropriate treatment.

Background of self-injurers
Though not exclusively, the person seeking treatment is usually from middle to upper class background, of average to high intelligence, and has low self-esteem. Nearly 50% report physical and/or sexual abuse during his or her childhood. Many report (as high as 90%), that they were discouraged from expressing emotions, particularly anger and sadness.

Behavior Patterns
Many who self-harm use multiple methods. Cutting arms or legs is the most common practice. Self-injurers may attempt to conceal the resultant scarring with clothing, and if discovered, often make excuses as to how an injury happened.

Reasons for SI Behaviors
Self-injurers commonly report they feel empty inside, over or under stimulated, unable to express their feelings, lonely, not understood by others and fearful of intimate relationships and adult responsibilities. Self-injury is their way to cope with or relieve painful or hard-to-express feelings, and is generally not a suicide attempt. But relief is temporary, and a self-destructive cycle often develops without proper treatment.

Dangers of SI Behaviors

Self-injurers often become desperate about their lack of self-control and the addictive-like nature of their acts, which may lead them to true suicide attempts. The self-injury behaviors may also cause more harm than intended, which could result in medical complications or death. Eating disorders and alcohol or substance abuse intensify the threats to the individual’s overall health and quality of life.

The Diagnoses of SI Behaviors
The diagnosis for someone who self-injures can only be determined by a licensed psychiatric professional. Self-harm behavior can be a symptom of several psychiatric illnesses: personality disorders (esp. borderline personality disorder); bipolar disorder (manic depression); major depression; anxiety disorders (esp. obsessive-compulsive disorder); as well as psychoses such as schizophrenia.

SI Behaviors Treatment
Self-injury treatment options include outpatient therapy, partial (6-12 hours a day) and inpatient/residential hospitalization. When the behaviors interfere with daily living, such as employment and relationships, and are health or life-threatening, a specialized self-injury hospital program with an experienced staff is recommended.

The effective treatment of self-injury is most often a combination of medication, cognitive/behavioral therapy, and interpersonal therapy, supplemented by other treatment services as needed. Medication is often useful in the management of depression, anxiety, obsessive-compulsive behaviors, and the racing thoughts that may accompany self-injury. Cognitive/behavioral therapy helps individuals understand and manage their destructive thoughts and behaviors.

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