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PubMed1998

[Self-mutilating hand and finger injuries among physicians suspected of insurance fraud].

27 cases of questionable self-mutilation among physicians (concerning finger and hand injuries) were analyzed retrospectively. The evaluation based on files of the insurance companies, reconstructive examinations and experimental investigations. Three typical cases are described in detail, the "victims" were suspected to have committed a special kind of fraud in order to claim financial compensation from their accident-insurance companies; the contract included special invalidity payments for finger injures (so-called "Gliedertaxe"). Many of these physicians had worked in the surgical field: apart from one 38-year-old female all of them were males, aged between 41 and 66 years. The mutilating instruments were often circular saws, sometimes chain saws and a great variety of other tools, for example hatchet, big scissors and other sharp instruments. By means of forensic-medical expertise and criminalistic investigations the insurance companies were able to demonstrate clearly that the amputation was voluntarily self-inflicted. The forensic-medical argumentation concerning intentional self-mutilation included the so-called execution position of the finger, the injury pattern, the investigations of blood stains and ergonometric aspects.

Adult↗
PubMed2000

Squamous cell carcinoma of the urethral process in a horse with hemospermia and self-mutilation behavior.

A 14-year-old Arabian stallion was examined because of acute hemospermia. The stallion was used in an artificial breeding program and had a 6-year history of low-grade hemospermia and a 4-year history of self-mutilation behavior. During previous examinations, minor irritation of the urethral process was identified as the source of the bleeding. Physical examination revealed a mucosal ulceration in the distal portion of the urethra. Histologic examination of a biopsy specimen from this area revealed low-grade squamous cell carcinoma. The urethral process was excised, and the hemospermia resolved. Frequency of self-mutilation behaviors also decreased after surgery, suggesting that there may have been a link between irritation of the urethral process and development of self-mutilation behavior.

Animals↗
PubMed1978

Life threatening self-mutilation of the nose.

Potentially life threatening self-mutilation of the nose in a patient with a severe passive aggressive character disorder is described. The phenomenological and psychodynamic features of this case are contrasted with those of schizophrenia and factitious dermatoses with similar excoriations.

Adult↗
PubMedDate not supplied

Living on the edge: the current phenomenon of self-mutilation in adolescents.

The purpose of this article is to share current knowledge about adolescent self-mutilation (SM), and to discuss treatment approaches for affected teens and young adults. One in eight American teenagers experiences depression or anxiety. The growing phenomenon of SM is a particularly worrisome coping mechanism used by teens and young adults to deal with stress and sadness. The incidence of SM is increasing, and might be fueled by current trends in music and media that highlight violent and self-injurious behaviors. SM represents a "cry for help" by adolescents who are suffering. Self-mutilators who repeatedly cut themselves with razors, scissors, knives, or sharp glass are not attempting suicide, but are seeking to relieve extreme anxiety, tension, or pain. Medical literature regarding SM is limited, and evidence-based treatment approaches have not been documented; however, early discovery of SM and the development of a multifaceted treatment approach that incorporates the child, family, and trusted practitioners could be instrumental in managing SM. There is hope that antidepressant medications may also be beneficial. Research is needed to identify successful treatment approaches, and to discover the best ways to educate teens, families, educators, and community leaders about the prevalence of SM in our youth.

Adolescent↗
PubMed1996

Report of a case of male genital self-mutilation and review of the literature, with special emphasis on the effects of the media.

Genital self-mutilation is seldom reported; fewer than 100 cases have been reported in the literature to date. Few studies have examined the factors that may lead susceptible individuals to undertake this act. We report here on a case of genital self-mutilation by a 22-year-old man who cut off his penis with an electric chain saw. This patient, who also demonstrated borderline intellectual functioning as evidenced by psychological testing, was likely influenced by the popular media, which was showcasing the criminal trials of John and Lorena Bobbitt at the time of the patient's act.

Adult↗
PubMed1985

Self-mutilation and contagion: an empirical test.

Twenty-five subjects treated at a center for disturbed adolescents were observed over a 1-year period for signs of self-mutilative contagion. Statistical analysis confirmed that self-mutilation occurred in clusters throughout the year, suggesting that subjects imitated one another's behavior.

Adolescent↗
PubMed1990

Self-mutilation: diagnosis and practical treatment.

The management of self-inflicted lesions requires an understanding of the dynamics of the act of self-mutilation. The overview of practical techniques allows the non-psychiatrist physician to deal with self-inflicted disorders more effectively. The efficacy of behavioral and psychotherapeutic techniques is enhanced when combined with psychopharmaca.

Borderline Personality Disorder↗
PubMedDate not supplied

Nursing management of self-mutilation.

This article attempts to define and describe self-mutilation and offers an introductory view of its nursing management. Most importantly it enjoins nurses to self-consciously appraise their practice in this area and develop an unconditional acceptance of the validity of such unconventional behaviour.

Attitude of Health Personnel↗
PubMed1989

Female genital self-mutilation: case reports and literature review.

Three cases are reported that demonstrate the variety of clinical conditions in which female genital self-mutilation may be found. The most common variety appears to be the habitually self-harming individual with a severe personality disorder. One of the cases reported, however, is a woman with a delusional disorder whose body image distortions led her to ablate one of her labia majora. The three cases presented are discussed in the context of the eight cases previously reported of genital self-mutilation found in women.

Adult↗
PubMed1995

Self-mutilation, anorexia, and dysmenorrhea in obsessive compulsive disorder.

This report described 19 female patients (M = 23.5) diagnosed as obsessive compulsive disorder (OCD; DSM-III-R) who exhibited additional symptoms of self-mutilation, dysmenorrhea, and dysorexia. A biphasic pattern related to menstruation during the course of OCD emerged: Phase 1, amenorrheic--characterized by anorexia nervosa, amenorrhea, and aggressive behavior, and Phase 2, postamenorrheic--characterized by self-mutilation following the return of the menstrual cycle, dysorexia, and aggressive behavior. All mutilative acts were reported by the patients to be painless and consisted of slashes. Seventy percent of the patients were sexually abused during childhood. All patients underwent an open trial of clomipramine (M = 200 mg/day) for 6 months, and intensive behavior therapy for 8 weeks. Based on clinical observations and self-reports, there was a decrease in self-harm and OCD symptoms. The emergence of OCD, self-mutilation, dysorexia, and dysmenorrhea in a sequential manner may suggest a specific clinical syndrome or the presence of an OCD subset. A biological working hypothesis of a hypothalamic dysfunction with serotonergic participation was suggested.

Adolescent↗
PubMed1984

[Use of baclofen in a patient with severe self mutilation].

The authors have drawn up a report on an adult under observation, who, for years, showed signs of the self-mutilation which endangered his life. The use of "Baclofen" led to a reduction of this self-mutilation. The main action of the product was linked to the muscle relaxing properties of the molecule.

Adult↗
PubMed1995

A case study of female genital self-mutilation in schizophrenia.

A case of deliberate genital self-mutilation in a woman with familial schizophrenia is presented. Such behaviour, though well recognized in females with severe personality disorders, is extremely rare in female psychotics. The genital mutilation may be partially understood as a consequence of delusionally motivated action against a background of low self-esteem, premorbid body-image preoccupation, forced early sexual activity and hence profound ambivalence towards adult sexuality. Dealing with this constructively was hampered by a cognitive style characterized by impaired reasoning and reality testing. Tests of reasoning, judgement and reality testing showed deficits, and computed tomography revealed dilatation of the left frontal ventricular system. Both neuropsychological and psychodynamic factors appeared to be of relevance in this case.

Adult↗
PubMed1979

Self-mutilation of the eye.

While the act of self-enucleation is rare, other self-inflicted eye injuries may be more common. Six patients are reported who have documented histories of ocular self-mutilation. Several common factors are observed in these patients and in other cases reported in the literature: (1) the patient was judged to be psychotic; (2) the patient had a tyrannical conscience; (3) a source of guilt was present; (4) this guilt was displaced to the eye; and (5) an attempt at self-inflicted eye injury was followed by relief from anxiety when completed or by frustration when injury was prevented.

Adult↗
PubMed1983

Depression and hostility in self-mutilation.

The presence of depression and hostility among self-mutilating patients is investigated. Mutilators, depressives and controls comprised the research samples. Non-significant differences in intropunitive hostility and depression were found between the clinical groups. Specific item differences in the depression assessment indicated a definite qualitative rather than quantitative difference in depressive symptomatology between the clinical groups. The interaction between hostility and depression and the implications for management based on these results is discussed.

Adjustment Disorders↗
PubMed1998

[Self-mutilation as insurance fraud].

The case of a self-amputation of the left-sided forefinger is presented. It was an isolated smooth amputation near the basic ankle of the finger without any accompanying injury of other fingers. The victim (a physician) claimed financial compensation from his accident-insurance; his contract included special disability taxes for finger injuries. However, the insurance company did not pay but was able to demonstrate--by means of a medico-legal reconstructive expertise--that the amputation was voluntary and self-inflicted. The argumentation concerning self-mutilation is presented (including the so-called execution-position of the finger and ergonometric aspects). Concerning the surgical care, intervention and diagnostic procedures a detailed documentation of the case history and the morphology of the injury pattern are recommended (especially in isolated finger-amputations of the non-working hand.

Aged↗
PubMed1987

The stress inoculation training management of self-mutilating behavior: a case study.

A combination of techniques, based mainly on the stress inoculation training approach, was used to treat severe self-mutilating behavior in a 32-year-old woman who for 15 years had manifested different kinds of this type of behavior. In 18 therapy sessions over 6 weeks in a psychiatric inpatient setting she achieved complete control of the self-mutilating behavior. After a year of follow-up she was completely symptom free and had made additional social and personal gains.

Adult↗
PubMed1999

Self-mutilation in rabbits following intramuscular ketamine-xylazine-acepromazine injections.

Following hind leg intramuscular injections of ketamine, xylazine, and acepromazine, 4 of 6 rabbits exhibited self-mutilation of the digits. At necropsy, the affected sciatic nerve appeared enlarged. Lymphohistiocytic perineural inflammation and fibrosis were observed, together with nerve degeneration. Neuronal regeneration as the reason for self-mutilation is discussed.

Acepromazine↗
PubMed2000

New protective system preventing self-mutilation of rat surgical sites.

The paper presents a new approach to the rat self-mutilation mechanism, and introduces an appropriate protective system. Observations revealed that rats use three main implements to damage experimental sites, i.e., their teeth, forelegs, and hind legs. Ignoring even one of these factors diminishes the reliability of a protective system. Commonly used rat vests sometimes fail, since free fore- and hind legs may damage the system itself or the surgical area directly. A new system was designed to avoid these problems. A splint is glued to the fur of the rat neck and chest with fast-bonding glue, to prevent flexing the neck. Then, a vest is fabricated by wrapping adhesive tape around the chest and neck. One of the forelegs is immobilized by incorporating it into the tape vest. The action of the hind legs is neutralized by taping the feet with toes flexed. Such a protective system design is more reliable than those previously proposed, since teeth, forelegs, and hind legs are all prevented from self-mutilation. In addition, the tape vest and mittens fit the rat body well, and are easy to apply.

Animals↗