Self-Injurious Behaviors: Assessment and Treatment

Overview

Throughout history, people have invented many different ways to inflict direct and deliberate physical injury on themselves — without an intent to die. Even today, the concept and practice of self-injury is sanctioned by some cultures, although condemned by most.

This insightful work fills a gap in the literature on pathologic self-injury. The phenomenon of people physically hurting themselves is heterogeneous in nature, disturbing in its impact on the self and others, ...

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Overview

Throughout history, people have invented many different ways to inflict direct and deliberate physical injury on themselves — without an intent to die. Even today, the concept and practice of self-injury is sanctioned by some cultures, although condemned by most.

This insightful work fills a gap in the literature on pathologic self-injury. The phenomenon of people physically hurting themselves is heterogeneous in nature, disturbing in its impact on the self and others, frightening in its blatant maladaptiveness, and often indicative of serious developmental disturbances, breaks with reality, or deficits in the regulation of affects, aggressive impulses, or self states. Further complicating our understanding is the large and diverse scope of psychiatric conditions, such as pervasive developmental disorders, Tourette's syndrome, and psychosis, in which these behaviors occur.

This volume presents a comprehensive nosology of self-injurious behaviors, classifying them as stereotypic, major, compulsive, and impulsive (with greater emphasis on the last two categories because they are the most commonly seen). • The chapter on stereotypic self-injurious behaviors (highly repetitive, monotonous behaviors usually devoid of meaning, such as head-banging) focuses on the neurochemical systems underlying the various forms of stereotypic movement disorders with self-injurious behaviors, typically seen in patients with mental retardation and autism, and discusses their psychopharmacological management.• The chapter on psychotic, or major, self-injurious behaviors (severe, life-threatening behaviors, such as castration) presents a multidimensional approach to evaluating and treating patients with psychosis and self-injurious behaviors, including the neuroanatomy and neurobiology of sensory information processing as background for its discussion of neurobiological studies and psychopharmacological treatments.• Chapters on the neurobiology of and psychopharmacology and psychotherapies for compulsive self-injurious behaviors (repetitive, ritualistic behaviors, such as trichotillomania [hair-pulling]) offer much-needed biological research and the first empirical treatment studies on compulsive self-injurious behaviors, and argue that a distinction can indeed be made between compulsive and impulsive self-injurious behaviors.• Chapters on the neurobiology, psychopharmacology, and dialectic behavior and psychodynamic theory and treatment of impulsive self-injurious behaviors (habitual, chronic behaviors, such as skin picking) supplement the few neurobiological studies measuring impulsivity, aggression, dissociation, and suicide and detail the efficacy of various medications and psychotherapies.

An eminently practical guide with exhaustive references to the latest data and research findings, this concise volume contains clinical material and therapeutic interventions that can be used right away by clinicians to better understand and treat patients with these complex and disturbing behaviors.

American Psychiatric Publishing

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Editorial Reviews

Doody's Review Service
Reviewer: Patricia E. Murphy, PhD (Rush University Medical Center)
Description: Looking at the treatment of self-injurious behavior under the categories of behaviors related to developmental syndromes, self-violating acts during psychotic episodes, compulsive and impulsive behaviors, the authors offer a range of tools for assessment and treatment of this serious mental health problem.
Purpose: This is a volume in the Clinical Practice Series, which focuses on providing a comprehensive background on topics of interest to the practicing clinician. This offers a great benefit to the busy practitioner who may not have time to follow or collect the most recent research on this topic.
Audience: Although the book is written for those engaged in clinical practice, it also could serve as an excellent textbook. The chapters are written by experts in their field and provide entry into understanding this very complex disorder.
Features: By beginning with the self-injurious behaviors most clearly related to brain abnormalities and the accompanying studies of functions of neurotransmitters, brain functions, and genetic links, the book lays the background for this approach to all categories of self harm. By moving through treatment modalities for the four different groups, the benefits of a variety of approaches become clear. The placement of the chapter on dialectic behavior therapy, which offers several techniques of self management for the impulsive behaviors associated with borderline personality disorder, prepares for the following chapter on psychodynamic approaches. Developing skills to interrupt unhealthy behavior can lay the development of a stronger ego and a more cohesive self. The explanation of self-injury in response to past abuse would have been richer if the authors had included information about the psychobiology of trauma.
Assessment: This excellent book includes the latest understanding of the problem of self injurious behavior. The charts and summaries make it clear and useful for the busy clinician. Information from well chosen studies and extensive bibliographies offer a path to further exploration.
Booknews
This volume presents a nosology of self-injurious behaviors, classifying them as stereotypic, major, compulsive, and impulsive. Chapters cover both the theoretical and the practical as they discuss these categories in relation to phenomenology, biological and psychological theories, and pharmacological and psychotherapeutic treatment approaches. Contributors include psychiatrists, psychologists, clinical pharmacologists, and social workers from the United States and South Africa. Annotation c. Book News, Inc., Portland, OR (booknews.com)

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780880488082
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 2/28/2001
  • Pages: 224
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.50 (d)

Meet the Author

Daphne Simeon, M.D., is Assistant Professor and Director of Medical Student Education in the Department of Psychiatry at Mount Sinai School of Medicine in New York, New York.

Eric Hollander, M.D., is a Professor; Director of Clinical Psychopharmacology; Director of the Compulsive, Impulsive, and Anxiety Disorders Program; and Clinical Director of the Seaver Autism Research Center in the Department of Psychiatry at Mount Sinai School of Medicine, in New York, New York.

American Psychiatric Publishing

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Table of Contents

Introduction. Self-injurious behaviors: phenomenology and assessment. Stereotypic self-injurious behaviors: neurobiology and psychopharmacology. Psychotic self-injurious behaviors: phenomenology, neurobiology, and treatment. Compulsive self-injurious behaviors: neurobiology and psychopharmacology. Psychotherapies for compulsive self-injurious behaviors. Impulsive self-injurious behaviors: neurobiology and psychopharmacology. Dialectical behavior therapy for impulsive self-injurious behaviors. Psychodynamic theory and treatment of impulsive self-injurious behaviors. Index.

American Psychiatric Publishing

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