Health  Vol.2 No.4 , April 2010
Cutting and other forms of derma-abuse in adolescents
Cutting or self inflicted epidermal damage (derma-abuse) describes a number of blood- letting behaviours among adolescents. Unlike suicidal behaviour, it is associated with low lethality and the absence of suicidal attempts. The purpose of this study is two-fold: Firstly, to present and discuss vignettes of four young adolescents and secondly, to study the dynamics and characteristics of six derma-abusers who have attended Dual Group Therapy (DGT) concurrently with their parents for a six month period. Our findings suggest that patients involved in derma-abuse are generally non-suicidal but engage in comfort cutting for the psychological release of pain, tension reduction and anger management. There is a preponderance of females (80%) with an over-representation of mixed origin and borderline cultural states. In this small group, males amounted to 20% and were more bizarre, gruesome and brutal in their self-abuse. Of the total sample, 10% were of African origin, 60% were of Indian descent and 30% were of mixed ancestry. Psy- chodynamic factors explored in Dual Group Therapy (DGT) are the emphasis on non-suicidal intent, association with tension reduction, reclaiming power and mastery over self and others, life and death instincts, the significance of bloodletting in a socio-cultural context, trans- generational conflicts, dysfunctional family dynamics frequently with parental separation and sexual abuse and early sexual induction.

Cite this paper
nullMaharajh, H. and Seepersad, R. (2010) Cutting and other forms of derma-abuse in adolescents. Health, 2, 366-375. doi: 10.4236/health.2010.24055.
[1]   Kreitman, N. (1989) Can Suicide and Parasuicide be prevented? Journal of the Royal Society of Medicine, 82, 648-652.

[2]   Kessel, N. and McCulloch, W. (1966) Repeated acts of self harm and self injury. Journal of the Royal Society of Medicine, 59, 89-92.

[3]   Morgan, H.D., Burns-Cox, C.J., Pocock, H. and Pottle, S. (1975) Deliberate Self-Harm: Clinical and Socio-Economic Characteristics of 368 Patients. British Journal of Psychiatry, 127, 564-574.

[4]   Gratz, K.L. (2001) Measurement of deliberate elf harm: Preliminary data on the deliberate Self harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253-263.

[5]   Platt, S., Bille-Brahe, U., Kerkhof, A., et al. (1992) Parasuicide in Europe: The WHO/EURO multicentre study on parasuicide I. Introduction and preliminary analysis for 1989. Acta Psychiatrica Scandinavica, 85, 97-104.

[6]   Clarke, L. and Whitaker, M. (1998) Self Mutilation: Culture, contexts and nursing responses. Journal of Clinical Nursing, 7, 129-137.

[7]   Nock, M.K. and Prinstein, M.J. (2005) Contextual features and behavioural functions of self mutilation among adolescents. Journal of Abnormal Psychology, 114(1), 140-146.

[8]   Baral, I., Kora, K., Yuksel, S. and Sezgin, U. (1998) Self mutilating behaviour of sexually abused female adults in Turkey. Journal of Interpersonal Violence, 13, 427-437.

[9]   Brodsky, B.S., Cloitre, M., and Dulit, R.A. (1995) Relationship of dissociation to self mutilation and childhood abuse in borderline personality disorder. American Journal of Psychiatry, 152, 1788-1792.

[10]   Wikipedia, Self Injury. injury

[11]   Briere, J. and Gil, E. (1998) Self Mutilation in a clinical and general population samples: Prevalence, correlates and functions. American Journal of Orthopsychiatry, 68, 609-620.

[12]   Favazza, A.R. and Conterio, K. (1989) Female habitual self mutilators. Acta Psychiatrica Scand, 79, 283-289.

[13]   Muehlenkamp, J.J. (2005) Self Injurious behaviour as a separate clinical syndrome. American Journal of Orthopsychiatry, 75, 324-333.

[14]   Favazza, A.R. (1996) Bodies under Siege: Self Mutilation and Body modification in culture and psychiatry (2nd Edition). John Hopkins University Press, Baltimore.

[15]   Whitlock, J., Eckenrode, J. and Silverman, D. (2006) Self Injurious behaviours in a college population. Pediatrics, 117, 1939-1948.

[16]   Favazza, A.R. (1992) Repetitive self mutilation. Psychiatric Annals, 22, 60-63.

[17]   Gratz, K.L. (2006) Risk factors for deliberate self harm among female college-students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Ortho- psychiatry, 76, 238-250.

[18]   World Health Organization, Euro multicentre study of suicide.

[19]   Hawton, K., Rodham, K., Evans, E., and Weatherall, R. (2002) Deliberate self harm in adolescents: Self report survey in schools in England. British Medical Journal, 325, 1207-1211.

[20]   Castillo, K. (2007) Mental health crisis looms, expert says: Girls cutting themselves. The Trinidad Express.

[21]   Mohammed, R. (2008) Deliberate self-harm in a non- clinical population: Emotion and coping strategies. MSc. Thesis, University of the West Indies, St. Augustine.

[22]   Allum, S. (2008) Risk factors associated with deliberate self-harm. MSc. Thesis, University of the West Indies, St. Augustine.

[23]   Favazza A. R. (1998) The coming of age of self mutilation. Journal of Nervous and Mental Disease, 186, 259-268.

[24]   Suyemoto, K.L. (1998) The functions of self mutilation. Clinical Psychology Review, 18, 531-554.

[25]   Suyemoto, K.L., and Macdonald, M.L. (1995) Self cutting in female adolescents. Psychotherapy, 32, 162-171.

[26]   Messer, J.M. and Fremouw, W.J. (2008) A critical review of explanatory models for self-mutilating behaviors in adolescents. Clinical Psychology Review, 28(1), 162-78.

[27]   Young people and self harm: A national Inquiry. What do we already know? Prevalence, risk factors and models of intervention.

[28]   Harrington, R. and Dyer, E. (1993) Suicide and attempted suicide in adolescence. Current Opinion in Psychiatry, 6, 467-469.

[29]   Hawton, K. (1986) Suicide and attempted suicide among children and adolescents. Sage, London.

[30]   Wikipedia, Bloodletting. letting

[31]   Linehan, M.M. (1995) Understanding borderline personality disorder: The dialectic approach manual. Guilford Press, New York.

[32]   Cornell Research Program on Self Injurious Behaviour in Adolescents and Young Adults. What do we know about self-injury?