Journal of Postgraduate Medicine, Education and Research

Register      Login

VOLUME 53 , ISSUE 2 ( April-June, 2019 ) > List of Articles


Deliberate Self-harm: Bench to Bedside

Krishan Kumar, Adarsh Kohli, Rajeev Dogra, Samita Sharma

Keywords : Deliberate self-harm, Self-mutilation, Suicide

Citation Information : Kumar K, Kohli A, Dogra R, Sharma S. Deliberate Self-harm: Bench to Bedside. J Postgrad Med Edu Res 2019; 53 (2):79-84.

DOI: 10.5005/jp-journals-10028-1318

License: CC BY-NC 4.0

Published Online: 01-06-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Deliberate self-harm a non-fatal suicidal behavior is one of the major problems in many developing and developed countries. It is a major concern for clinicians and academicians, in which behavior is multiple and diverse in its presentation and often bewildering, vexing in the powers that drive them. To this day, general clinicians and research experts in the field of mental health have not agreed on which behaviors to include under the rubric of self-injury/deliberate self-harm/attempted suicide or on how to proceed and categorize them into a meaningful group. According to many researchers, deliberate self-harm refers to behavior through which individual deliberately inflict acute harm upon themselves, poison themselves, hang themselves or try to exhibit this behavior with nonfatal outcomes. Initially, these behaviors were often regarded as failed suicides. This view did not appear to be correct as the majority of the patients do not try to kill themselves, and there are substantial differences between communities in the prevalence of attempted suicide because these behaviors are somehow linked to attention-seeking rather resulting in death. All these behaviors share one thing in common that they occur in emotional turmoil, the degree of powerlessness and hopelessness of young people with low education, low income, unemployment, and difficulties in coping with life stress. These acts are often gratifying and cause minor to moderate harm. Some individuals repeatedly harm themselves, while others do it only once or a few times in their lifespan. Here we are trying to explore a few more issues related to deliberate self-harm.

PDF Share
  1. Kreitman N, Philip AE, Greer S, et al. Parasuicide. Br J Psychiatry.1969; 115:746-747.
  2. Simpson E, Zlotnick C, Begin A. Self-Injury Survey. Providence, RI. 1994
  3. Pao PN. The syndrome of delicate self-cutting. Br J Med Psychol 1969; 42:195-206.
  4. Graff H, Mallin R. The syndrome of the wrist cutter. Am J of Psychiatry, 124, 36-42.
  5. Rosenthal RJ, Rinzler C, Walsh R. Wrist-cutting syndrome. Am J Psychiatry.1972; 128:1363-1368.
  6. Morgan HG, Barton J, Pottle S, et al. Deliberate Self-Harm: a follow-up study of 279 patients. Br J Psychiatr 1976;128: 361-368.
  7. Favazza AR. Introduction. In strong M (ed.) A Bright Red Scream. New York: Penguin;16-17.
  8. Platt S, Bille-Brahe U, Kerkhof A, et al. Parasuicide in Europe: the WHO/EURO Multicentre Study on Parasuicide. I. Introduction and preliminary analysis for 1989. Acta Psychiatr Scand 1992;85:97-104.
  9. Self Injury Awareness Book, S. l.: First Signs, 2007, ISBN 0-9555506-0-2, archived from the original on 2008-09-23, retrieved 2008-05-26.
  10. Arensman E, Kerkhof AJFM. Classification of attempted suicide: a review of empirical studies 1963–1993.Suicide and Life-Threat. Behav 1996;26:46-67.
  11. Claes L, Vandereycken W. Self-injurious behaviour: differential diagnosis and functional differentiation. Compr Psychiatry 2007; 48:137-144.
  12. Menninger KA. A psychoanalytic study of the significance of selfmutilations. Psychoanalytic Quarterly.1935; 4:408-466.
  13. Schmidtke A, Bille-Brahe U, DeLeo D. Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989-1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand 1992;93: 327-338.
  14. Sourander A, Aromaa M, Pihlaskoski L, et al. Early predictors of deliberate self-harm among adolescents. A prospective follow-up study from age 3 to age 15. J Affect Disord 1996; 93:87-96.
  15. Petronis KR, Samuels JF, Moscicki EK, et al. An epidemiologic investigation of potential risk factors for suicide attempts. Soc Psychiatry Psychiatr Epidemiol 1990;25:193-199.
  16. Platt S, Hawton K. Suicidal behaviour and the labour market. In K Hawton and K Heeringen. International Handbook of suicide and attempted suicide (eds). Chichester: John Wiley & Sons. 2000.
  17. Gratz KL. Measurement of deliberate self-harm: preliminary data on the Deliberate Self-Harm Inventory. J of Psychopathol Behav Assess 2001;23:253-263.
  18. Hawton K, Fagg J. Repetition of attempted suicide: the performance of the Edinburgh predictive scales in patients in Oxford. Arch Suicide Res 1995;1:261-272.
  19. Beautrais, AL. Risk factors for suicide and attempted suicide among young people. Aust N Z J Psychiatry 2000;34:420-436.
  20. Mittendorfer-Rutz E, Rasmussen F, Wasserman D. Restricted fetal growth and adverse maternal psychosocial and socioeconomic conditions as risk factors for the suicidal behaviour of offspring: a cohort study. Lancet 2004;364:1135-1140
  21. Moscicki EK. Identification of suicide risk factors using epidemiologic studies. Psychiatr Clin North Am 1997;20:499-517.
  22. Magne-Ingvar U, Ojehagen A. Traskman-Bendz L. The social network of people who attempt suicide. Acta Psychiatrica Scandinavia 1992; 86:153-158.
  23. Eagles JM, Carson DP, Begg A, et al. Suicide prevention: a study of patients’ views. Br J of Psychiatry 2003;182:261-265.
  24. Malone KM, Oquendo MA, Haas GL, et al. Protective factors against suicidal acts in major depression: reasons for living. Am J of Psychiatry 2000;157:1084-1088.
  25. Dervic K, Oquendo MA, Grunebaum MF, et al. Religious affiliation and suicide attempt. Am J Psychiatry 2004; 161:2303-2308.
  26. Skegg, K, Nada-Raja S, Dickson N, et al. Sexual orientation and selfharm in men and women. Am J Psychiatry 2003;160:541-546.
  27. Jorm AF, Korten AE, Rodgers B, et al. Sexual orientation and mental health: results from a community survey of young and middle-aged adults. Br J Psychiatry 2002;180:423-427.
  28. De Leo D, Scocco P, Marietta P. Physical illness and parasuicide: evidence from the European Parasuicide Study Interview Schedule (EPSIS/WHO-EURO). Int J of Psychiatry Med 1999;29: 149-163.
  29. Klonsky ED. The functions of deliberate self injury: a review of the evidence. Clin Psychol Rev.2007;27:226-239.
  30. Romanczyk RG, Lockshin S. Connor JO. Psychophysiology and issues of anxiety and arousal. In: Self-injurious behaviour: Analysis, assessment, and treatment. 1992.
  31. Walsh BW. Treating Self–Injury: A Practical Guide. 2006;3-70. New York: The division of Guilford press
  32. Paul JP, Catania J, Pollack L, et al. Suicide attempts among gay and bisexual men: Lifetime prevalence and antecedents. Am J Public Health 2002;92:1338-1345
  33. Michelle L. Deliberate self-harm in adolescents. Singapore Med J 2015;56(6):306-309.
  34. Linehan MM. Skills training manual for treating borderline personality disorder. 1993 New York: Guilford Press.
  35. Chapman AL, Gratz KL, Brown MZ. Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behav Res Ther 2006; 44(3):371-394.
  36. Hayes SC, Wilson KG, Gifford EV, et al. Experiential avoidance and behavioural disorders: A functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol 1996;64: 1152-1168.
  37. Maris RW. The relationship of nonfatal suicide attempts to completed suicide. Assessment and Prediction of suicide.1992. Guilford Press, New York. 362-380.
  38. Kreitman N, Casey P. Repetition of parasuicide: an epidemiological and clinical study. Br J Psychiatr 1988;153:792-800.
  39. Bancroft J, Skrimshire A, Casson, J. People who deliberately poison or injure themselves: their problems and their contacts with helping agencies. Psychol Med 1977;77:289-303.
  40. Bateman AW, Fonagy P. Psychotherapy for personality disorders. In: The Oxford text book of psychiatry. Gelder MG, Andreason NC, Lopez-Irisbor Jr JJ, et al. Vol 1, 893-899. New York: Oxford University Press.
  41. Bohus M, Limberger M, Ebner U, et al. Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behaviour. Psychiatry Res 2000;95:251-260.
  42. Wood, A, Trainor G, Rothwell J, et al. Randomized trial of group therapy for repeated deliberate self-harm in adolescents. J Am Academy of Child and Adoles Psychiatry 2001;40(11): 1246-1253.
  43. National Institute for Clinical Excellence (NICE). Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. London: National Institute of Clinical Excellence. 2004.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.