A critical review of explanatory models for self-mutilating behaviors in adolescents.

The present paper presents critical reviews of studies that have explored models of adolescent self-mutilation. Current definitional problems were addressed, as well as a proposal for a classification system of self-mutilation. Seven historically significant explanatory models were included, the sexual/sadomachistic model, the depersonalization model, the interpersonal/systemic model, the suicide model, the physiological/biological model, the affect regulation model, and the behavioral/environmental model. Each model was briefly described, and studies were critiqued according to methodology, research design, and basis upon which authors provided support or rejection of a model. Suggestions for improvement in the literature were made throughout the paper. Studies often overlapped within the models, and the strongest empirical support was shown for the behavioral/environmental model, which included components of the affect regulation model, interpersonal/systemic model, and depersonalization model. Explaining adolescent self-mutilation is a complex task, and evidence provided in this paper suggests that aspects of several models, or an integration of models, likely contribute to the understanding of this phenomenon.