M J Marchetto1. 1. Department of Psychiatry and Behavioural Sciences, University College London, UK. m.marchetto@londonmet.ac.uk
Abstract
OBJECTIVES: This study examines (a) the extent to which repetitive skin-cutting is most prevalent among women and those with a history of trauma; and (b) among those skin-cutters without a history of trauma, the extent to which borderline personality disorder (BPD) features as a primary diagnosis and whether disturbed parental bonding might be associated with this form of self-harm. METHOD: Details of gender and reported experiences of trauma were recorded for a large, consecutive sample of skin-cutters (N=517) who attended a general hospital. Psychiatric diagnoses and parental bonding instrument (PBI) scores were obtained for a subsample of skin-cutters (N=81) and comparison group participants without experiences of trauma. RESULTS: No gender differences were observed among skin-cutters, most of whom reported experiences of trauma. BPD was recorded for a minority of those skin-cutters without a history of trauma. PBI scores discriminated between non-BPD skin cutters and non-BPD comparison participants without a history of trauma. CONCLUSIONS: Although these results provide further confirmation of a potential association between prior trauma and repetitive skin-cutting, they rigorously challenge the validity of reported gender differences for this behaviour. Further, this study has identified that repetitive skin-cutting can arise independently of BPD and prior trauma. Clinical implications of these results and suggested directions for future research are discussed.
OBJECTIVES: This study examines (a) the extent to which repetitive skin-cutting is most prevalent among women and those with a history of trauma; and (b) among those skin-cutters without a history of trauma, the extent to which borderline personality disorder (BPD) features as a primary diagnosis and whether disturbed parental bonding might be associated with this form of self-harm. METHOD: Details of gender and reported experiences of trauma were recorded for a large, consecutive sample of skin-cutters (N=517) who attended a general hospital. Psychiatric diagnoses and parental bonding instrument (PBI) scores were obtained for a subsample of skin-cutters (N=81) and comparison group participants without experiences of trauma. RESULTS: No gender differences were observed among skin-cutters, most of whom reported experiences of trauma. BPD was recorded for a minority of those skin-cutters without a history of trauma. PBI scores discriminated between non-BPD skin cutters and non-BPD comparison participants without a history of trauma. CONCLUSIONS: Although these results provide further confirmation of a potential association between prior trauma and repetitive skin-cutting, they rigorously challenge the validity of reported gender differences for this behaviour. Further, this study has identified that repetitive skin-cutting can arise independently of BPD and prior trauma. Clinical implications of these results and suggested directions for future research are discussed.