OBJECTIVE: This exploratory study sought demographic and clinical
correlates of self-mutilation (self-injury without suicidal intent) in
borderline personality disorder. METHOD: Among 124 consecutively admitted
inpatients with borderline personality disorder, there were 62 who did not
mutilate themselves, 23 who mutilated themselves infrequently (fewer than
five lifetime events), and 39 who mutilated themselves frequently (five or
more lifetime events); each received ratings on numerous measures of
psychopathology. RESULTS: Compared to nonmutilators, frequent mutilators
were significantly more likely to be in outpatient treatment at the time of
admission and had more weeks of prior outpatient and inpatient treatment;
they were also more likely to receive comorbid diagnoses of current major
depression, anorexia nervosa, and bulimia nervosa. Frequent mutilators had
significantly higher group means on the Beck Scale for Suicidal Ideation,
were more likely to have attempted suicide, and were more likely to have
attempted suicide more often than both infrequent mutilators and
nonmutilators. The adjusted odds ratios from logistic regression analyses
demonstrated that major depression, bulimia nervosa, number of prior
suicide attempts, and acute suicidal ideation were each associated with
greater risk of frequent mutilation. CONCLUSIONS: Borderline patients who
frequently mutilate themselves may represent a subgroup of especially high
utilizers of psychiatric treatment who are at particularly high risk for
suicidal behavior and for comorbid major depression and eating disorders.
Clinicians should consider aggressive treatment of comorbid axis I
disorders and careful assessment of suicide risk in these patients.
Abstract Teaser