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Annu Rev Clin Psychol. 2010;6:339-63. doi: 10.1146/annurev.clinpsy.121208.131258.


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Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA.


People have engaged in self-injury-defined as direct and deliberate bodily harm in the absence of suicidal intent-for thousands of years; however, systematic research on this behavior has been lacking. Recent theoretical and empirical work on self-injury has significantly advanced the understanding of this perplexing behavior. Self-injury is most prevalent among adolescents and young adults, typically involves cutting or carving the skin, and has a consistent presentation cross-nationally. Behavioral, physiological, and self-report data suggest that the behavior serves both an intrapersonal function (i.e., decreases aversive affective/cognitive states or increases desired states) and an interpersonal function (i.e., increases social support or removes undesired social demands). There currently are no evidence-based psychological or pharmacological treatments for self-injury. This review presents an integrated theoretical model of the development and maintenance of self-injury that synthesizes prior empirical findings and proposes several testable hypotheses for future research.

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