1. Mennick, Fran BSN, RN


Self-injurious behavior signals a need for careful assessment


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It's estimated that 12% to 38% of high school and college students engage in self-injurious behavior, which is defined as "self-inflicted destruction of the body for purposes not socially sanctioned and without suicidal intent" by the authors of a new study. Many researchers consider self-injurious behavior to be a coping mechanism that helps the practitioner avoid suicide.


In a Web-based survey, 2,875 undergraduate and graduate students at two northeastern U.S. universities reported on their self-injurious behavior and suicidality (suicidal ideation, plan, gesture, or attempt). One-quarter of the students reported suicidality, self-injurious behavior, or both. Of these, 28% of students who practiced self-injurious behavior also experienced suicidality.


Having engaged in more than one lifetime episode of self-injury was the strongest predictor of suicidality. Students who reported self-injurious behavior and suicidality were more likely to have a history of sexual or emotional abuse, severe psychological distress, or an eating disorder and were more likely to be black and to consider themselves bisexual. They were less likely to seek help informally. Students reporting self-injurious behavior and suicidality were 2.8 times more likely to experience suicidal ideation, 5.6 times more likely to have a plan, 7.3 times more likely to have made a gesture (such as writing a note), and 9.6 times more likely to have made a suicide attempt.


The authors contend that while self-injurious behavior itself is not a suicidal gesture, it can predict suicidality in some people. Therefore, people who engage in self-injurious behavior should be assessed for suicidality and referred for mental health treatment.


Fran Mennick, BSN, RN

Figure. Laura Snow o... - Click to enlarge in new windowFigure. Laura Snow of Longview, Texas, engaged in self-injurious behavior-specifically, cutting herself-for four years before seeking help to stop the practice. The authors of a study found that although self-injury itself is not a suicidal behavior, it was associated with suicidality in 28% of self-injurers.

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