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Self-Harm in Adolescence

Iva Buresová

The author discusses the subject of self-harm in adolescence, considering the historical context of the development of its classification system. She presents an overview of theoretical fundamentals as well as models of behavior derived from them. Within the context of current research studies, she describes its prevalence, etiology, and comorbidity. The author specifies the basic protective and risk factors as well as all important influences. She presents the diagnostic tools currently used in research and clinical practice including the description of key approaches to prevention, therapy and treatment. This book includes the results of a unique research study mapping the lexical trace of the term self-harm in adolescents and the differences in perception of this term among those without own practice, with mediation and with personal, often repeated experience.
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1 Self-Harm Classification System Development

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1   Self-Harm Classification System Development

Self-harm seemingly appears to be a rather new phenomenon of the current age. However, the truth is that similarly to, for example, mental anorexia, its manifestations can be traced to the distant past1, portrayed in a number of works of art and bibliographical references. The term self-harm itself was first used in the case study by L. E. Emerson The Case of Miss A: a Preliminary Report of a Psychoanalytic Study and Treatment of a Case of Self-Mutilation (Emerson, 1913). Emerson refers here to this behaviour as “self-mutilation”, building his study on psychoanalytical basis and recognising self-cutting as a symbolic substitution of masturbation. Menninger (1935; 1938) is another important author in this context. He uses the same term in his studies and further distinguishes between suicidal and self-harming behaviour. However, he considers self-harm a partial suicide. In his view, this behaviour has a specific purpose and occurs under various circumstances and conditions. He defines it as a certain “weakened” wish to die and therefore introduces the term “partial suicide” into specialised literature (Menninger, 1935, p. 460). Menninger states 6 types of self-mutilation: 1) neurotic (biting nails, picking off scabs, excessive hair pulling out, unnecessary cosmetic procedures), 2) religious (self-whipping, etc.), 3) maturity ceremonies (circumcision, hymen removal), 4) psychotic (eyes, ears, genitals removal, extreme amputation), 5) based on organic damage (where repeated head banging and biting and breaking fingers occur, etc.) and 6) conventional (cutting nails and hair and shaving)...

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