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14 - Self-injurious behaviour

from Part II - Psychopathology and special topics

Published online by Cambridge University Press:  15 December 2009

By
John Hillery  and
Philip Dodd
Edited by
Nick Bouras  and
Geraldine Holt
John Hillery
Affiliation:
Consultant Psychiatrist, Stewarts Hospital, Palmerstown, Dublin
Philip Dodd
Affiliation:
Consultant Psychiatrist, Psychiatry of Learning Disability, St. Michael's House, Dublin
Nick Bouras
Affiliation:
King's College London
Geraldine Holt
Affiliation:
King's College London
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Summary

Introduction

People who self-injure present a major challenge to services and carers. The behaviour can cause negative emotions in observers. Even experienced clinicians can find themselves conflicted.

Tsiouris et al. (2003) have reservations that the behaviour as manifested by people with intellectual disabilities (ID) can be considered an Axis I psychiatric diagnosis in the context of DSM IV (American Psychiatric Association, 1994). Favazza and Rosenthal (1993) classified self-mutilation in general into three basic types: major, superficial and stereotypic. They claim that the stereotypic type is most commonly seen in institutionalized people with ID, although the authors admit that not all self injury in people with ID is of this type.

Indeed, we know that people with ID can show myriad forms of self injury. It can be resistant to treatment. Kahng et al. (2002) in reviewing the literature on behavioural intervention stated that, though there is much research ‘the disorder persists’. Self-injurious behaviour can be responsible for much medical, psychological and social morbidity.

Definition

Variations in the definition make comparison between epidemiological studies difficult. The definitions used generally include the requirement that the actions cause tissue damage. Oliver et al. (1987) reported that the ‘tissue damage’ criterion proved robust when judging the ability of different informants to agree on caseness.

Definitions also vary according to the frequency and severity of the self-injury (e.g. Borthwick-Duffy, 1994 vs. O'Brien, 2003).

Type
Chapter
Information
Psychiatric and Behavioural Disorders in Intellectual and Developmental Disabilities , pp. 225 - 237
Publisher: Cambridge University Press
Print publication year: 2007

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  • Self-injurious behaviour
    • By John Hillery, Consultant Psychiatrist, Stewarts Hospital, Palmerstown, Dublin, Philip Dodd, Consultant Psychiatrist, Psychiatry of Learning Disability, St. Michael's House, Dublin
  • Edited by Nick Bouras, King's College London, Geraldine Holt, King's College London
  • Book: Psychiatric and Behavioural Disorders in Intellectual and Developmental Disabilities
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543616.015
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  • Self-injurious behaviour
    • By John Hillery, Consultant Psychiatrist, Stewarts Hospital, Palmerstown, Dublin, Philip Dodd, Consultant Psychiatrist, Psychiatry of Learning Disability, St. Michael's House, Dublin
  • Edited by Nick Bouras, King's College London, Geraldine Holt, King's College London
  • Book: Psychiatric and Behavioural Disorders in Intellectual and Developmental Disabilities
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543616.015
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  • Self-injurious behaviour
    • By John Hillery, Consultant Psychiatrist, Stewarts Hospital, Palmerstown, Dublin, Philip Dodd, Consultant Psychiatrist, Psychiatry of Learning Disability, St. Michael's House, Dublin
  • Edited by Nick Bouras, King's College London, Geraldine Holt, King's College London
  • Book: Psychiatric and Behavioural Disorders in Intellectual and Developmental Disabilities
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543616.015
Available formats
×