Academic journal article North American Journal of Psychology

Self-Injury in the Schools: An Exploratory Analysis of Midwest School Counselors' Knowledge and Experience

Academic journal article North American Journal of Psychology

Self-Injury in the Schools: An Exploratory Analysis of Midwest School Counselors' Knowledge and Experience

Article excerpt

Self-injurious behaviors are not a new phenomenon. Favazza (1988) first studied "self mutilation" after an October 1985 broadcast of the Phil Donahue show discussing self-abuse. Prior to Favazza's research, self-injurious behaviors had been examined within diagnostic criteria for disorders such as borderline personality disorder. Although self-injurious behaviors are one of the criteria for personality disorders, the behavior has been observed in individuals without obvious personality disorders (Crowe & Bunclark, 2000). Favazza (1988) began to examine the phenomenon of self-injury as a stand-alone behavior, but it is only within the past few years that self-injurious behaviors have begun to be examined in non-clinical populations. Ross and Heath (2002, 2003) and Muehlenkamp and Gutierrez (2004) found that youth engaging in self-injury in community samples identified feelings of anxiety, depression, and hostility on self-report measures. However, there was no indication that these youth had been formally diagnosed with any psychiatric disorders.

There now exists a new generation of youth without significant psychiatric issues who self-injure (Derouin & Bravender, 2004; Walsh, 2006). Many youth who fall into the "new generation" appear well adjusted and appear to have supportive networks around them. However, they are turning to self-injury to help cope with the stresses of life.

Within the literature on self-injurious behaviors there is no consensus regarding the definition of self-injury (Best, 2005), and the behavior of self-injury is also labeled differently by researchers (e.g., self-mutilation, non-suicidal self-harm behaviors, self-harm, cutting, etc.). This lack of consistency makes it difficult to gauge the true magnitude of the problem and the treatment considerations. Adding to the issue of scope, many youth who self-injure go unnoticed by others. Best noted that those youth who receive help for self-injury may in fact "constitute only the tip of the iceberg" (2005, p. 277).

For the purpose of this paper, the term self-injury will be used. Walsh (2006) defined four components of self-injury; it is "1) intentional, 2) self-effected, 3) low lethality bodily harm of a socially unacceptable nature, 4) performed to reduce psychological distress" (p. 4). The first component explained that the act of self-injury is intentional; it does not include accidental injury such as cutting oneself while shaving (Walsh). The second component of the definition is that self-injury is self-effected (i.e., injuring oneself or allowing someone else to injure you). In the popular press, Booth (2004) discussed the allure of "cutting clubs" among adolescents, who self-injure with others and may even cut on each other during the process. The third component included the notion that self-injury is a low lethality behavior (i.e., the goal is not to put one's life at risk; Walsh, 2006). A common myth is that self-injurious behaviors are synonymous with suicide. Muehlenkamp and Gutierrez (2007) found that individuals engaging in self-injury were motivated to live, which is in contrast to some individuals with suicidal ideation. Researchers (e.g., Crowe & Bunclark, 2000; Favazza & Conterio, 1989; Zila & Kiselica, 2001) have found enough differences between the behaviors, such as their purpose, to indicate that self-injury is not synonymous with suicide.

The purpose of self-injury is bodily harm or some type of tissue damage that is of a socially unacceptable nature (Walsh, 2006). For example, a popular practice among adolescents is carving words or names on their bodies. Other popular forms of self-injury include scratching, burning, preventing wounds from healing, picking, and hair pulling (Derouin & Bravender, 2004). Young adolescents may self-injure with common items such as pencil erasers (i.e., rubbing the eraser on the skin until it causes injury) or cutting the skin with paper clips or notebook wire. …

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