Self-injury and self-mutilation. Nursing approaches.

Self-injury/self-mutilation behaviors often are associated with organic conditions, such as mental retardation, encephalitis, Lesch-Nyhan disease, de Lange syndrome, Tourette's syndrome, acute intoxication, Addison's disease, and various behavioral and personality disorders. Among the many reasons why individuals resort to self-injury/self-mutilation are to reduce tension, the communication of intense or depressive emotions, dissociative experiences, or to gain control of earlier traumatic experiences through reenactment. The treatment of clients who engage in self-injury/self-mutilation must focus on improving communication skills, raising self-esteem, identifying support persons and groups, and eliminating positive and negative reinforcement.