Clinical Correlates of Self-Mutilation in Turkish Male Substance-Dependent Inpatients

Bakirkoy State Hospital for Mental Health and Neurological Disorders, Alcohol and Drug Research, Treatment and Training Center (AMATEM), Istanbul, Turkey.
Psychopathology (Impact Factor: 2.08). 02/2006; 39(5):248-54. DOI: 10.1159/000094722
Source: PubMed


The aim of this study was to evaluate the prevalence of self-mutilation (SM) in male substance-dependent inpatients, and to investigate the relationship of SM with childhood abuse and neglect, axis I disorders and personality disorders.
Participants were 112 consecutively admitted male substance dependents (56 alcohol and 56 drug). Substance dependence was diagnosed by means of the Structured Clinical Interview for DSM-IV (SCID-I, Turkish version). Patients were evaluated by the Childhood Abuse and Neglect Questionnaire, SCID-I, SCID-II, Beck Depression Inventory and Beck Anxiety Inventory.
Among substance-dependent patients, SM was found to be present in 33% (SM group). Mean age and educational status were lower in the SM group. Moreover rates of being single, history of childhood physical and emotional abuse and neglect, suicide attempt history and personality disorder were higher. Mean depression and anxiety scores were also higher in the SM group. Personality disorder, physical abuse, suicide attempt history and drug dependency were predictors for SM.
SM is more common in drug dependents than alcohol dependents. Also results of this study suggest that among Turkish substance dependents SM might be related to the presence of personality disorder and childhood physical abuse and suicide attempts.

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    • "Prompting events for SM were not assessed. Although psychometric properties of this questionnaire were not evaluated because the studies (including present study) were not designed for this purpose, it was successfully used in previous studies [10] [11] [17] [18] "
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    ABSTRACT: The aim of this study was to investigate the relationship of self-mutilation (SM) with anger and aggression in male substance-dependent inpatients. Also, we wanted to evaluate the mediator effect of childhood trauma on these relationships while controlling variables such as age, substance of dependence (alcohol/drug), and negative effect. Participants were consecutively admitted 200 male substance-dependent inpatients. Patients were investigated with the Self-mutilative Behaviour Questionnaire, the Childhood Trauma Reports, the Buss-Perry's Aggression Questionnaire, the State-Trait Anger Expression Inventory, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. Rate of being married, current age, and age onset of regular substance use were lower, whereas being unemployed and history of childhood trauma (HCT) were higher in group with SM (n = 124, or 62.0%). Higher mean scale scores were found in SM group. Predictors of SM were being younger, impaired anger control, and physical aggression in logistic regression model. Being younger and the outward expression of anger (anger-out) predicted SM in the subgroup of patients without HCT, whereas being younger, severity of anger, and the inward expression of anger (anger-in) predicted SM in the subgroup of patients with HCT. Thus, to reduce self-mutilative behavior among substance-dependent patients, clinicians must improve anger control, particularly in younger patients. Type of strategy for coping with anger, which must be worked on, may differ in different subgroup patients, that is, focusing anger toward self among those with HCT, whereas anger toward others among those without.
    Comprehensive psychiatry 05/2011; 53(3):252-8. DOI:10.1016/j.comppsych.2011.04.061 · 2.25 Impact Factor
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    • "Thus, evaluating the function of SM in a population such as of alcohol-dependent patients with PTSD comorbidity is important. We assume that a possible influence of SM and PTSD has clinical relevance, because there are reports that both phenomena may point to treatment resistance in this population (Kural et al., 2004; Evren et al., 2006). "
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    ABSTRACT: The aim of this study was to investigate the relationship between self-mutilation (SM) and posttraumatic stress disorder (PTSD) in male alcohol-dependent inpatients, and to examine whether there is something unique about self-mutilaters with the PTSD/alcohol-dependence co-morbidity, compared with self-mutilaters without PTSD in this population. Participants were 156 consecutively admitted male alcohol-dependent inpatients. Patients were investigated with the Self-mutilative Behaviour Questionnaire (SMBQ), the Traumatic Experiences Checklist (TEC), the Clinician Administered PTSD Scale (CAPS), the Symptom Checklist-Revised (SCL-90-R) and the Michigan Alcoholism Screening Test (MAST). Among alcohol-dependent inpatients, 34.0% (n=53) were considered as group with SM. Rate of being unemployed, history of any trauma, history of suicide attempt and lifetime PTSD diagnosis were higher, whereas being married, current age, age at onset of regular alcohol use and duration of education were lower in the group with SM. Mean scores of SCL-90 subscales, TEC and MAST were higher in the SM group. Although SM might be related with PTSD among male alcohol-dependent inpatients, predictors of SM were age at onset of regular alcohol use, history of suicide attempt, anxiety, depression and hostility. Age at onset of regular alcohol use, history of suicide attempt, anxiety, depression and somatisation predicted SM in the subgroup of patients without PTSD, whereas hostility predicted SM alone in the subgroup of patients with PTSD. Results support the anti-suicide and the affect-regulation models of SM in the non-PTSD group, whereas they support the hostility model of SM in the subgroup with PTSD in alcohol-dependent inpatients. Thus, to reduce self-mutilative behaviour (SMB)among alcohol-dependent patients, clinicians must address different subjects in different subgroup patients; that is, focussing hostility in those with PTSD co-morbidity.
    Psychiatry Research 03/2011; 186(1):91-6. DOI:10.1016/j.psychres.2010.07.045 · 2.47 Impact Factor
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    • "Thus, findings that the presence of DSH is associated with higher levels of emotion dysregulation among a sample of SUD patients with already heightened levels of emotion dysregulation provide further support for the relevance of emotion dysregulation to DSH. Moreover, findings of a unique association between emotion dysregulation and DSH when controlling for the influence of BPD, PTSD, childhood abuse, and substance use severity (all of which are considered risk factors for both DSH and emotion dysregulation; see Evren et al. 2006, 2008; Fox et al. 2008; Gratz et al. 2006, 2008; Harned et al. 2006; Tull et al. 2007; Zlotnick et al. 1999) suggest that emotion dysregulation may uniquely contribute to our understanding of DSH among SUD patients. "
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    ABSTRACT: Despite the emphasis on the role of emotion dysregulation in deliberate self-harm (DSH), no studies have examined this association among patients with substance use disorders (SUD). This study examined if emotion dysregulation is heightened among SUD inpatients with (vs. without) DSH, and if the association between DSH and emotion dysregulation remains significant when controlling for their shared association with risk factors for both, including borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), childhood abuse, and substance use severity. Findings indicate heightened emotion dysregulation among SUD patients with (vs. without) DSH, and provide evidence of a unique association between emotion dysregulation and DSH when controlling for BPD, PTSD, childhood abuse, and substance use severity. Findings also highlight the particular relevance of three dimensions of emotion dysregulation to DSH among SUD patients: limited access to effective emotion regulation strategies, difficulties engaging in goal-directed behaviors when distressed, and emotional nonacceptance.
    Cognitive Therapy and Research 12/2010; 34(6):544-553. DOI:10.1007/s10608-009-9268-4 · 1.70 Impact Factor
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