Self-injurious behaviour in patients with anorexia nervosa: A quantitative study

L. Smithuis, N. Kool-Goudzwaard, J.M. de Man-van Ginkel, H. van Os-Medendorp, T.N. Berends, A. Dingemans, L. Claes, A.A. van Elburg, B. van Meijel

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Many patients with an eating disorder report difficulties in regulating their emotions and show a high prevalence of self-injurious behaviour. Several studies have stated that both eating disorder and self-injurious behaviour help emotion regulation, and are thus used as coping mechanisms for these patients. We aimed to determine the prevalence of self-injurious behaviour, its characteristics and its emotion-regulation function in patients with anorexia nervosa or an eating disorder not otherwise specified (n=136). Methods: A cross-sectional design using a self-report questionnaire. Mann-Whitney U-tests were conducted to compare the background and clinical variables between patients with self-injurious behaviour and patients without this type of behaviour. Changes in emotional state before and after self-injurious behaviour were tested by Wilcoxon signed rank tests. Results: Our results showed a 41% prevalence of self-injurious behaviour in the previous month. Patients who performed self-injurious behaviour had a statistically significant longer treatment history for their eating disorder than those who did not. Whereas 55% of self-injuring patients had a secondary psychiatric diagnosis, only 21% of participants without self-injurious behaviour did. Regarding the impact of self-injurious behaviour, our results showed a significant increase in "feeling relieved" and a significant decrease in "feeling angry at myself", "feeling anxious" and "feeling angry at others". This indicates that self-injurious behaviour can be regarded as an emotion-regulation behaviour. Participants were usually aware of the causes of their self-injurious behaviour acts. Conclusions: Professionals should systematically assess the occurrence of self-injurious behaviour in eating disorder patients, pay special attention to patients with more severe and comorbid psychopathology, and those with a long treatment history. This assessment should be followed by a functional analysis of the self-injurious behaviour and by effective therapeutic interventions alongside the eating disorder treatment.

Original languageEnglish
Article number26
Number of pages10
JournalJournal of Eating Disorders
Volume6
Issue number1
DOIs
Publication statusPublished - 2018

Keywords

  • Anorexia nervosa
  • Feeding and eating disorders
  • Self-harm
  • Self-injurious behaviour

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