Skip to main content Accessibility help

Self-injurious behaviour in persons with a mental handicap: an epidemiological study in an Irish population

  • John Hillery Hillery and Michael Mulcahy (a1)


Objective: The repeated, self-inflicted, non-accidental injury known as Self Injurious Behaviour (SIB) is a cause of severe stress to carers and a challenge to multi-disciplinary teams working with people with a mental handicap. A need for Irish data on this problem was answered by collecting a representative cohort and following its members up to record the prevalence of SIB.

Method: The group studied included all people with an IQ of less than 50 (that is those in the moderate, profound and severe range of intellectual ability) whose place of origin was within the geographical borders of a single community care area. Following a preliminary tracing process, each person was followed up for one calendar month using a specifically prepared format to record daily occurrence of SIB.

Results: The group resulting from the tracing process consisted of 429 people (= 0.4% of the total population), 62 (=14 %) of this group exhibited SIB, during the time of the study. Of the demographic variables studied SIB was found to be related to IQ. Of those who self-injured those who showed multiple topographies and those who showed the greatest frequency of SIB were more likely to be found in the population who lived in a residential facility.

Conclusions: SIB is related to IQ but in a non-linear way suggesting that factors other than IQ militate against more severely handicapped people displaying this behaviour. SIB is not caused by living in a residential centre however our results suggest that living in a residential facility is the result of displaying SIB. This study suggests that implications for future treatment approaches and service provision for those exhibiting SIB in Ireland can be made with reference to research from other countries.


Corresponding author

Department of Psychiatry UCD &Stewart's Hospital, Palmerstown, Dublin 20, Ireland.


Hide All
1.Favazza, A. Normal and deviant self-mutilation: an essay-review. Transcultural Psychiatric Research Review 1989; 26(2): 113–27.
2.Favazza, A, Rosenthal, R. Diagnostic issues in self-mutilation. Hosp Community Psychiatry 1993; 44(2): 134–40.
3.Emerson, E. Self-injurious behaviour; Some of the challenges it presents. Mental Handicap 1990; 18: 92–8.
4.Gualtieri, C. The differential diagnosis of self-injurious behaviour in mentally retarded people. Psychopharmacol Bull 1989; 25(3): 358–63.
5.Fahmy, V, Jones, R. Theories of the aetiology of self-injurious behaviour: a review. Ir J Psychology 1990; 11(3): 261–76.
6.Oliver, C, Murphy, G, Corbett, J. Self-injurious behaviour in people with mental handicap: a total population study. J Ment Defic Res 1987; 31: 147–62.
7.Winchel, R, Stanley, M. Self-injurious behaviour: a review of the behaviour and biology of self-mutilation. Am J Psychiatry 1991; 148 (3): 306–17.
8.Quine, L, Pahl, J. Examining the causes of stress in families with mentally handicapped children. Br J Social Work 1985; 15: 501–17.
9.Tausig, M. Factors in family decision making about placement for developmentally disabled individuals. Am J Ment Retard 1985; 89: 352–61.
10.Shlalock, R, Harper, R, Genung, T. Community integration of mentally retarded adults: community placement and program success. Am J Ment Def 1985; 89: 352–61.
11.Rojalm, J. Self-injurious and stereotypic behaviour of non-institutionalised mentally retarded people. Prevalence and classification. Am J Ment Def 1986; 91(3): 268–76.
12.Murphy, A. Self-injurious behaviour in the mentally handicapped: an update. Newsletter of the Journal of Child Psychology and Psychiatry 1985; 7: 211.
13.Saloviita, T. Self-injurious behaviour in an institution for mentally handicapped persons. An epidemiological study. Helsinki: Mental Handicap Research Unit, 1988.
14.Mulcahy, M, Reynolds, A. Census of mental handicap in the Republic of Ireland 1981. Medicosocial Research Board of Ireland, 1984.
15.Ballinger, B. Minor self-injury. Br J Psychiatry 1971; 118: 535–8.
16.Griffen, J, Williams, D, Stark, M, Altmeyer, B, Mason, M. Self-injurious behaviour: a state wide prevalence survey of the extent and circumstances. Appl Res Ment Retard 1986; 7: 105–16.
17.Griffen, J, Ricketts, R, Williams, D, Locke, B, Altmeyer, B, Stark, M. A community survey of self-injurious behaviour among developmentally disabled children and adolescents. Hosp Community Psychiatry 1987; 38(9): 959–62.
18.Maurice, P, Trudel, G. Self-injurious behaviour prevalence and relationships to environmental events. In: Hollis, J, Meyers, C, eds. Life-threatening behaviour. Washington: AAMD Monograph, 1982: 81103.
19.Singh, N. Prevalence of self-injury in institutionalised retarded children. N Z Med J 1977;86:325–7.
20.Maisto, C, Baumeister, A, Maisto, A. An analysis of variables related to self-injurious Behaviour among institutionalised retarded persons. J Ment Def Res 1978; 22: 2736.
21.Kebbon, L, Windahl, S. Self-injurious behaviour. Results of a nationwide survey among mentally retarded persons in Sweden. Seventh World Congress of IASSMD 1985.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed