CLINICAL CORRELATES OF SELF-MUTILATION IN BORDERLINE PERSONALITY-DISORDER

Objective: This exploratory study sought demographic and clinical corr elates of self-mutilation (self-injury without suicidal intent) in bor derline personality disorder. Method: Among 124 consecutively admitted inpatients with borderline personality disorder, there were 62 who di d not mutilate themselves, 23 who mutilated themselves infrequently (f ewer than five lifetime events), and 39 who mutilated themselves frequ ently (five or more lifetime events); each received ratings on numerou s measures of psychopathology. Results: Compared to nonmutilators, fre quent mutilators were significantly more likely to be in outpatient tr eatment at the time of admission and had more weeks of prior outpatien t and inpatient treatment; they were also more likely to receive comor bid diagnoses of current major depression, anorexia nervosa, and bulim ia nervosa. Frequent mutilators had significantly higher group means o n the Beck Scale for Suicidal Ideation, were more likely to have attem pted suicide, and were more likely to have attempted suicide more ofte n than both infrequent mutilators and nonmutilators. The adjusted odds rations from logistic regression analyses demonstrated that major dep ression, bulimia nervosa, number of prior suicide attempts, and acute suicidal ideation were each associated with greater risk of frequent m utilation. Conclusions: Borderline patients who frequently mutilate th emselves may represent a subgroup of especially high utilizers of psyc hiatric treatment who are at particularly high risk for suicidal behav ior and for comorbid major depression and eating disorders. Clinicians should consider aggressive treatment of comorbid axis I disorders and careful assessment of suicide risk in these patients.