Alexithymia, Depression, And Self-Mutilation In Adolescent Girls

Alexithymia, Depression, and Self-Mutilation in Adolescent Girls
Aurélie Lambert and Anton F. de Man
Bishop’s University
Fifteen adolescent French girls with a recent history of self-mutilation and 18 adolescent girls without such a history participated in a study of the relationship between alexithymia, depression, and self-mutilation. Results of correlational analyses showed that depressionand alexithymia -particularly its “difficulty in identifying feelings and differentiating them from bodily sensations” factor- were significantly related to selfmutilation. Sequential logistic regression analysis showed that depression and the alexithymia factor as a set reliably distinguished between those who self-mutilated and those who did not. Of the two independent variables, depression wasidentified as the better predictor of selfmutilating behavior. Although the “difficulty in identifying feelings and differentiating them from bodily sensations” factor of alxithymia did have an effect independent of depression, much of the relationship between this factor and self-mutilation appeared to be the result of mediation by depression.

Self-mutilation may be defined as “a volitionalact to harm one’s own body without intention to cause death” (Yaryura-Tobias, Neziroglu, & Kaplan, 1995, p. 33). This deliberate, physically violent but non-suicidal act done to oneself by oneself (Alderman, 1997) may take many forms. Some of these are culturally sanctioned (e.g., tattooing, body piercing) whereas others are pathological in nature (Favazza, 1996). Pathological self-mutilation may becategorized into major, stereotypic, and superficial/moderate self-mutilation (Favazza, 1998; Favazza, & Rosenthal, 1993). Major self-mutilation involves acts which result in significant tissue damage (e.g., castration) and are usually associated with psychosis and intoxication. Stereotypic self-mutilation consists of stereotypic, rhythmic acts such as head banging and self-biting, commonly seenin conditions such as severe mental retardation and Tourette’s syndrome. Superficial/moderate self-mutilation consists of superficial behavior such as skin cutting, burning, and scratching. The present study concerned itself with this last category. More specifically, it focused on adolescent girls showing self-cutting behavior. Self-mutilation usually begins in late childhood or early adolescenceand can continue for up to 20 years (Favazza & Rosenthal, 1993); the
Author info: Correspondence should be sent to: Dr. A. F. de Man, Department of Psychology, Bishop’s University, Sherbrooke, J1M 0C8, Canada. (ademan@ubishops.ca) North American Journal of Psychology, 2007, Vol. 9, No. 3, 555-566. © NAJP

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rates are highest among adolescents.Although the behavior has been observed in boys (Ross & Heath, 2004), the typical self-mutilator is a single, adolescent or young adult female (Favazza & Conterio, 1989; Pattison & Kahan, 1983; Raine, 1982; Suyemoto & MacDonald, 1995). Self-mutilation is repetitive in nature and distinct from suicidal behavior. Self-mutilators usually cut more than once (Bach-y-Rita, 1974; Himber, 1994; Simpson, 1980)but have no intention to cause death (Graff & Mallin, 1967). They distinguish between self-mutilative acts and suicidal ones (Herpertz, Steinmeyer, Marx, Oidtmann, & Sass, 1995), and, unlike suicide attempters, generally experience a feeling of relief following the act (Alderman, 1997; Favazza, 1996; Pattison & Kahan, 1983). Solomon and Farrand (1996) suggested that self-mutilation may be anadaptive alternative to suicide; however, those who cut themselves can have suicidal ideation which can lead to suicidal behavior. In fact, Stanley, Gameroff, Michalson, and Mann (2001) reported that between 55% and 85% of self-mutilators have made at least one suicide attempt. Although there has been a growing interest in early trauma as a factor in the development of self-mutilative behavior...