The complexities of motivation and behavior in those who inflict violence upon themselves are challenging for both helping professionals and those they treat, yet we are fortunate as clinicians to have an abundance of theoretical literature and empirical data on the topic of self-inflicted violence (SIV). This study critically reviews extant literature of trauma-related SIV behavior and the interventions currently employed by those who work with individuals who engage in this pervasive and perplexing clinical phenomenon.
Empirical research has consistently linked childhood maltreatment with the adult sequelae of SIV; the nature of this relationship however, is complicated. This review focuses on several questions: (a) whether SIV behavior is universally defined in terms of function and meaning; (b) whether literature and research have adequately studied differences in those who engage in SIV in terms of age, gender, ethnicity, socioeconomic status, education, and sexual orientation; and (c) whether contemporary interventions adequately treat and prevent SIV behavior.
This paper seeks to condense selected literature in order to raise awareness of the multiple ways of understanding SIV. Gathering and fostering awareness of all aspects of the SIV phenomenon may help to continue the commitment toward understanding, prevention, and treatment of this behavior. Chapter 1 includes five sections that provide the reader with a broad overview of this project, which comprise the following:
(a) Statement of the Problem; (b) Purpose of the Study; (c) Significance of the Study; (d) Scope of the Study; and (e) Definition of Terms. Statement of the Problem Approximately 4% of general population and 21% of clinical samples report engaging in socially unsanctioned SIV behavior, which involves a predictive increase among clinical and general populations as social stressors mount (Favazza & Conterio, 1988; Walsh & Rosen, 1988; Briere & Gil, 1998).
Although research suggests SIV is predominately a female phenomenon, it trends toward a narrowing prevalence among males and females (Briere & Gil, 1998). Many authors describe the typical individual who engages in SIV behavior as White, female, adolescent or young adult, single, middle to upper class, intelligent, and attractive (Darche, 1990; Favazza & Conterio, 1988); this unfortunate stereotypical description may be a reason why research has focused more on women than on men.
Empirical research with male samples remains scarce and qualitative research and case studies appear nonexistent. Additionally and unfortunately, a review of available research revealed few published studies that investigate prevalence, meaning, and function of SIV among diverse ethnicities and geriatric populations. Despite the widespread use of SIV as a means of coping with stressors, many professionals and laypeople lack understanding regarding the functions and meanings behind the behavior and continue to mistake SIV for suicide attempts.
The two behaviors, however, serve very different end functions. Purpose of the Study The purpose of the present study was to (a) conduct a critical review of SIV literature and research; (b) integrate existing and relevant literature into a written analysis; (c) review theoretical approaches that focus on prevention and treatment of SIV behavior, including individual and group modalities; and (d) provides recommendations for intervention, integration, and research needs. Significance of the Study
The present study has significance for psychological practice because of the long-term physical and mental consequences to those who engage in SIV and the need for psychotherapists to better understand and respond to this behavior in their clients. By reviewing SIV literature, the results of this paper will (a) increase understanding of SIV behavior; (b) promote a multidimensional approach to the treatment and prevention of SIV; (c) advance knowledge of the current and future impact of this increasingly prevalent phenomenon on the mental health care system; and (d) explore areas of needed research.
By evaluating documented approaches that focus on the treatment and prevention of SIV, the hope is to provide more effective interventions, preventions, and measurements for SIV behavior. The present study integrates SIV into a larger conceptual framework that can be utilized in various fields, such as medicine, mental health, social services, education, and the criminal justice system. An integrated multidimensional concept of SIV can provide a comprehensive understanding of and effective assessment tools and interventions for SIV behavior.
Scope of the Study The present study evaluates the findings of SIV research and literature that met the following criteria: (a) is an English language publication; (b) relates to people who practice SIV; (c) identifies meanings, predictors, measurements, and/or effective interventions for SIV behavior; and (d) identifies epidemiology, etiology, motivations, and functions of SIV behavior. Definition of Terms Amygdala The amygdala is a primitive area of the brain located in the core and composed of a collection of nuclei that controls the fear response.
It is involved in the fear response as well as the non-verbal and unconscious memory of fear. Childhood Emotional Abuse Emotional abuse (psychological abuse and verbal abuse) includes acts or omissions by the parents or other caregivers that have caused, or could cause, serious behavioral, cognitive, emotional, or mental disorders (Fromm, 2001). Childhood Emotional and Physical Neglect Childhood neglect is characterized by failure to provide for the child’s basic needs. Neglect can be physical, educational, or emotional.
It can include refusal or delay in seeking health care, inattention to the child’s needs for affection, failure to provide needed psychological care, and spousal abuse in the child’s presence (Fromm, 2001). Childhood Physical Abuse Physical abuse was defined by Briere & Gil (1998) as reports of “parental actions committed before the subject was 17 years old that were either a) intentional and resulted in bruises, scratches, broken bones, or broken teeth; or b) involved punching, kicking, or biting” (p. 611).