Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T12:08:22.671Z Has data issue: false hasContentIssue false

Self-injury, psychiatric symptoms, and defense mechanisms: Findings in an Italian nonclinical sample

Published online by Cambridge University Press:  16 April 2020

I. Sarno*
Affiliation:
Department of Psychology, University of Milan-Bicocca, IV floor, Building U6, Piazza dell’Ateneo Nuovo 1, 20126Milan, Italy
F. Madeddu
Affiliation:
Department of Psychology, University of Milan-Bicocca, IV floor, Building U6, Piazza dell’Ateneo Nuovo 1, 20126Milan, Italy
K.L. Gratz
Affiliation:
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500, North State Street, Jackson, MS 39216, United States
*
*Corresponding author. Tel.: +39 3287 343 650 (cell); fax: +39 6448 3705. E-mail address: irene.sarno@unimib.it (I. Sarno).
Get access

Abstract

Introduction

This study provides data on the rates, characteristics, and correlates of self-injury (SI) in an Italian nonclinical sample, a population previously unexamined within the SI literature. This study examined the associations between SI and defense mechanisms, as well as the differences between self-injurers (episodic and recurrent) and non self-injurers with regard to the severity and variety of their psychiatric symptoms and psychological distress.

Materials and methods

Five hundred and seventy-eight university students (82.5% female; mean age = 22.3; S.D. = 3.4) were administered a battery of self-report questionnaires, including the “Deliberate Self Harm Inventory” for SI, the Response Evaluation Measure-71 for defense mechanisms, and the “Symptom Checklist-90-Revised” for psychological distress and psychiatric symptoms.

Results

One hundred and nineteen participants (20.6%) reported having engaged in SI at least once during their lifetime. Individuals with recurrent SI (SI ≥ 5) reported significantly higher levels of all psychiatric symptoms and many maladaptive defense mechanisms than individuals without SI. Results also provided evidence for differences between individuals with recurrent and episodic SI.

Conclusion

Results suggest that recurrent self-injurers are distinguished from both episodic self-injurers and non self-injurers by their greater use of maladaptive defense mechanisms, rather than their lesser use of adaptive defenses. Further, results suggest that recurrent self-injurers differ from episodic self-injurers not in terms of the severity of their psychiatric symptoms, but the variety and number of these symptoms.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association; 2000.Google Scholar
Andover, MS, Pepper, CM, Ryabchenko, KA, Orrico, EG, Gibb, BESelf-mutilation and symptoms of depression, anxiety, and borderline personality disorder. Suicide Life Threat Behav 2005;35:581591.CrossRefGoogle ScholarPubMed
Bjarehed, J, Lundh, LGDeliberate self-harm in 14-year-old adolescents: how frequent is it, and how is it associated with psychopathology, relationship variables, and styles of emotional regulation. Cogn Behav Ther 2008;37:2637.CrossRefGoogle Scholar
Bond, MEmpirical studies of defense style: relationships with psychopathology and change. Harv Rev Psychiatry 2004;12:263278.CrossRefGoogle Scholar
Briere, J, Gil, ESelf-mutilation in clinical and general population samples: prevalence, correlates and functions. Am J Orthopsychiatry 1998;68:609620.CrossRefGoogle ScholarPubMed
Brown, S, Williams, K, Collins, APast and recent deliberate self-harm: emotion and coping strategy differences. J Clin Psychol 2007;63:791803.CrossRefGoogle ScholarPubMed
Claes, L, Vandereycken, W, Vertommen, HSelf-injurious behaviours. Eur Eat Disord Rev 2003;11:379396.CrossRefGoogle Scholar
Conti, LRepertorio delle scale di valutazione in psichiatria. Roma: Società Editrice Universo; 2001.Google Scholar
De Leo, D, Heller, TSWho are the kids who self-harm?An Australian self-report school survey. Med J Aust 2004;181:140144.CrossRefGoogle Scholar
Derogatis, LSCL-90-R. Administration, scoring and procedures manual. Baltimore: Clinical Psychometric Research; 1983.Google Scholar
Dubo, ED, Zanarini, MC, Lewis, RE, Williams, AAChildhood antecedents of self-destructiveness in borderline personality disorder. Can J Psychiatry 1997;42:6369.CrossRefGoogle ScholarPubMed
Favazza, ARBodies under siege: self-mutilation and body modification in culture and psychiatry. 2nd edition. Baltimore: The Johns Hopkins University Press; 1996.Google Scholar
Favazza, ARThe coming of age of self mutilation. J Nerv Ment Dis 1998;186:259268.CrossRefGoogle ScholarPubMed
Favazza, AR, Conterio, KFemale habitual self-mutilators. Acta Psychiatr Scand 1989;79:283289.CrossRefGoogle ScholarPubMed
Gerra, G, Leonardi, C, Cortese, E, Zaimovic, A, Dell’Agnello, G, Manfredini, Met al.Childhood neglect and parental care perception in cocaine addicts: relation with psychiatric symptoms and biological correlates. Neurosci Biobehav Rev 2009;33:601610.CrossRefGoogle ScholarPubMed
Gollust, SE, Eisenberg, D, Golberstein, EPrevalence and correlates of self-injury among university students. J Am Coll Health 2008;56:491498.CrossRefGoogle ScholarPubMed
Gratz, KLMeasurement of deliberate self-harm: preliminary data on the Deliberate Self-Harm Inventory. J Psychopathol Behav Assess 2001;23:253263.CrossRefGoogle Scholar
Gratz, KLRisk factors for and functions of deliberate self-harm: an empirical and conceptual review. J Clin Psychol 2003;10:192205.Google Scholar
Gratz, KL, Chapman, ALThe role of emotional responding and childhood maltreatment in the development and maintenance of deliberate self-harm among male undergraduates. Psyc Men Masc 2007;8:114.CrossRefGoogle Scholar
Gratz, KL, Conrad, SD, Roemer, LRisk factors for deliberate self-harm among college students. Am J Orthopsychiatry 2002;72:128140.CrossRefGoogle ScholarPubMed
Gunderson, JGBorderline personality disorder: a clinical guide. Washington, DC: American Psychiatric Press; 2001.Google Scholar
Haines, J, Williams, CL, Brain, KL, Wilson, GVThe psychophysiology of self-mutilation. J Abnorm Psychol 1995;104:471489.CrossRefGoogle ScholarPubMed
Hawton, K, Kingsbury, S, Steinhardt, K, James, A, Fagg, JRepetition of deliberate self-harm by adolescents: the role of psychological factors. J Adolesc 1999;22:369378.CrossRefGoogle ScholarPubMed
Herpertz, SSelf-injurious behavior: psychopathological and nosological characteristics in subtypes of self-injurers. Acta Psychiatr Scand 1995;91:5768.CrossRefGoogle ScholarPubMed
Hessel, A, Schumacher, J, Geyer, M, Brähler, ESymptom-Checkliste SCL-90-R: Testtheoretische Überprüfung und Normierung an einer bevölkerungsrepräsentativen Stichprobe. Diagnostica 2001;47:2739.CrossRefGoogle Scholar
Hilt, LM, Cha, CB, Nolen–Hoeksema, SNonsuicidal self-injury in young adolescent girls: moderators of the distress-function relationship. J Consult Clin Psychol 2008;76:6371.CrossRefGoogle ScholarPubMed
Holi, MM, Sammallahti, PR, Aalberg, VADefense styles explain psychiatric symptoms: an empirical study. J Nerv Ment Dis 1999;187:654660.CrossRefGoogle ScholarPubMed
Kernberg, OFBorderline personality organization. J Am Psychoanal Assoc 1967;15:641685.CrossRefGoogle ScholarPubMed
Klonsky, EDThe functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev 2007;27:226239.CrossRefGoogle Scholar
Klonsky, ED, Moyer, AChildhood sexual abuse and non-suicidal self-injury: meta analysis. Br J Psychiatry 2008;192:166170.CrossRefGoogle ScholarPubMed
Klonsky, ED, Oltmanns, TF, Turkheimer, EDeliberate self-harm: prevalence and psychological correlates. Am J Psychiatry 2003;160:15011508.CrossRefGoogle ScholarPubMed
Linehan, MMCognitive-behavioral treatment for borderline personality disorder: the dialectics of effective treatment. New York: The Guilford Press; 1993.Google Scholar
Lloyd-Richardson, E, Perrine, N, Dierker, L, Kelley, MLCharacteristic and functions on non-suicidal self-injury in a community sample of adolescents. Psychol Med 2007;37:1183.CrossRefGoogle Scholar
Lundh, L.-G., Karim, J, Quilisch, EDeliberate self-harm in 15-year-old adolescents: a pilot study with a modified version of the Deliberate Self-Harm Inventory. Scand J Psychol 2007;48:3341.CrossRefGoogle ScholarPubMed
Miotto, P, De Coppi, M, Frezza, M, Preti, AEating disorders and suicide risk factors in adolescents: an Italian community-based study. J Nerv Ment Dis 2003;191:437443.CrossRefGoogle ScholarPubMed
Miotto, P, Preti, ASuicide ideation and social desirability among school-aged young people. J Adolesc 2008;31:519533.CrossRefGoogle ScholarPubMed
Muehlenkamp, JSelf-injurious behavior as a separate clinical syndrome. Am J Orthopsychiatry 2005;75:324333.CrossRefGoogle ScholarPubMed
Muehlenkamp, J, Gutierrez, PAn investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide Life Threat Behav 2004;34:1223.CrossRefGoogle Scholar
Muris, P, Winands, D, Horselenberg, RDefense styles, personality traits, and psychopathological symptoms in nonclinical adolescents. J Nerv Ment Dis 2003;191:771780.CrossRefGoogle ScholarPubMed
Nixon, MK, Cloutier, PF, Aggarwal, SAffect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. J Am Acad Child Adolesc Psychiatry 2002;41:13331341.CrossRefGoogle ScholarPubMed
Paivio, SC, McCulloch, CRAlexithymia as a mediator between childhood trauma and self-injurious behaviors. Child Abuse Negl 2004;28:339354.CrossRefGoogle ScholarPubMed
Prunas, A, Baio, A, Pozzoli, S, Cioffi, G, Madeddu, FLa versione italiana della Response Evaluation Measure-71 (REM-71): risultati preliminari. Ricerche Psicologia 2006;4:7592.Google Scholar
Prunas, A, Madeddu, F, Pozzoli, S, Gatti, C, Shaw, RJ, Steiner, HThe Italian version of the Response Evaluation Measure (REM-71). Compr Psychiatry 2009;50:369377.CrossRefGoogle Scholar
Ross, RR, McKay, HBSelf-mutilation. Lexington, MA: Lexington Book; 1979.Google Scholar
Ross, SR, Heath, NLA study of the frequency of self-mutilation in a community sample of adolescents. J Youth Adolesc 2002;31:6777.CrossRefGoogle Scholar
Sammallahti, P, Aalberg, V, Pentinsaari, JPDoes defense style vary with severity of mental disorder? An empirical assessment. Acta Psychiatr Scand 1994;90:290294.CrossRefGoogle ScholarPubMed
Steinberg, M, Schnall, MThe stranger in the mirror. Dissociation: the hidden epidemic. New York: Cliff Street Books (HarperCollins); 2001.Google Scholar
Steiner, H, Araujo, KB, Koopman, CThe Response Evaluation Measure (REM-71): a new instrument for the measurement of defenses in adult and adolescent. Am J Psychiatry 2001;158:467473.CrossRefGoogle Scholar
Steiner, H, Erickson, SJ, MacLean, P, Medic, S, Plattner, B, Koopman, CRelationship between defenses, personality, and affect during a stress task in normal adolescents. Child Psychiatry Hum Dev 2007;38:107119.CrossRefGoogle ScholarPubMed
Suyemoto, KLThe functions of self-mutilation. Clin Psychol Rev 1998;18:531554.CrossRefGoogle ScholarPubMed
Suyemoto, KL, McDonald, MLSelf-cutting in female adolescents. Psychother Theory Res Pract Train 1995;32:162171.CrossRefGoogle Scholar
van der Kolk, BA, Perry, C, Herman, JLChildhood origins of self-destructive behavior. Am J Psychiatry 1992;148:16651671.Google Scholar
Vanderlinden, J, Vandereycken, WTrauma, dissociation, and impulse dyscontrol in eating disorders. London: Taylor & Francis; 1997.Google Scholar
Whitlock, J, Eckenrode, J, Silverman, DSelf-injurious behaviors in a college population. Pediatrics 2006;117:19391948.CrossRefGoogle Scholar
Whitlock, JL, Powers, JL, Eckenrode, JThe virtual cutting edge: the internet and adolescent self-injury. Dev Psychol 2006;42:407417.CrossRefGoogle ScholarPubMed
Yates, TM, Tracy, AJ, Luthar, SSNonsuicidal self-injury among “privileged” youths: longitudinal and cross-sectional approaches to developmental process. J Consult Clin Psychol 2008;76:5262.CrossRefGoogle ScholarPubMed
Zanarini, MC, Frankenburg, FR, Ridolfi, ME, Jager-Hyman, S, Hennen, J, Gunderson, JGReported childhood onset of self-mutilation among borderline patients. J Personal Disord 2006;20:915.CrossRefGoogle ScholarPubMed
Zoroglu, SS, Tuzun, U, Sar, V, Tutkun, H, Savas, HA, Ozturk, Met al.Suicide attempt and self-mutilation among Turkish high school students in relation with abuse, neglect and dissociation. Psychiatry Clin Neurosci 2003;57:119126.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.