Suyemoto K L
Saint Mary's College of Maryland, USA.
Clin Psychol Rev. 1998 Aug;18(5):531-54. doi: 10.1016/s0272-7358(97)00105-0.
While pathological self-mutilating behavior has been clinically examined for over 65 years, and much of the literature hypothesizes some function for the behavior, there has been little attempt to integrate or differentiate between different functional ideas. This review uses six functional models extracted from the literature to organize a discussion of the multiple functions of self-mutilation, acknowledging the overdetermined nature of the behavior and attempting to understand how self-mutilation can serve multiple functions simultaneously. Contextual information about the definition, prevalence, phenomenology, patient characteristics, associated diagnoses, and associated symptoms of self-mutilation is first presented. Six functional models are then presented: the environmental model, the antisuicide model, the sexual model, the affect regulation model, the dissociation model, and the boundaries model. Support for these models in the empirical and theoretical literature is presented and treatment implications are explored.
尽管病理性自我伤害行为在临床上已被研究超过65年，并且许多文献对该行为的某些功能提出了假设，但几乎没有人尝试整合不同的功能观点或对其进行区分。本综述使用从文献中提取的六个功能模型来组织关于自我伤害多种功能的讨论，承认该行为具有多重决定因素的性质，并试图理解自我伤害如何能同时发挥多种功能。首先介绍了关于自我伤害的定义、患病率、现象学、患者特征、相关诊断及相关症状的背景信息。然后介绍了六个功能模型：环境模型、反自杀模型、性模型、情绪调节模型、解离模型和边界模型。阐述了实证和理论文献中对这些模型的支持，并探讨了其对治疗的启示。
