A functional approach to the assessment of self-mutilative behavior.

This study applied a functional approach to the assessment of self-mutilative behavior (SMB) among adolescent psychiatric inpatients. On the basis of past conceptualizations of different forms of self-injurious behavior, the authors hypothesized that SMB is performed because of the automatically reinforcing (i.e., reinforced by oneself; e.g., emotion regulation) and/or socially reinforcing (i.e., reinforced by others; e.g., attention, avoidance-escape) properties associated with such behaviors. Data were collected from 108 adolescent psychiatric inpatients referred for self-injurious thoughts or behaviors. Adolescents reported engaging in SMB frequently, using multiple methods, and having an early age of onset. Moreover, the results supported the structural validity and reliability of the hypothesized functional model of SMB. Most adolescents engaged in SMB for automatic reinforcement, although a sizable portion endorsed social reinforcement functions as well. These findings have direct implications for the understanding, assessment, and treatment of SMB.