Repetitive self-mutilation (RSM) has become increasingly prevalent among adolescents. Empirical research has pinpointed several correlates of this behavior, but the initiation and maintenance of RSM among adolescents are not well understood. The experiential avoidance model (EAM) proposes that self-mutilation is a behavior that allows for the avoidance or alteration of unwanted internal experiences, and that it is negatively reinforced with repetition. The current study explored the usefulness of the EAM as an explanatory theory for adolescent RSM, with the additional incorporation of issues of social context. Adolescents (N = 211) from three school-based samples completed self-report questionnaires. One-third of students reported at least one incident of purposeful, non-suicidal self-mutilation and 16% had engaged in self-mutilation repeatedly within the past 6 months. Both regression and group analyses indicated that adolescents who engage in RSM report greater psychological distress, a greater incidence of functionally equivalent behaviors, and greater exposure to self-mutilation among peers and/or in the media, when compared to their counterparts who have not engaged in RSM. Suicidal ideation/behaviors were consistently the strongest predictors of current self-mutilation behaviors. Clinical implications, limitations, and suggestions for future research are discussed.

The primary interest of this investigation concerned the self-injurious thoughts and behaviors (SITBs) of inpatient adolescents. Previous researchers have provided descriptive information regarding either automatic (or intrinsic) and social components using the Self-Injurious Thoughts and Behaviors Interview (SITBI). However, the presence and trends of these components have not firmly been established, suggesting the need to explore this area further. Eighty-two adolescent inpatients were selected and interviewed using the SITBI to evaluate the predictive ability of self-reported self-injurious behavior with regard to social and automatic, negative and positive functions. Results showed that depending on the type of thought or behavior displayed one could discern the motivation behind their actions. Automatic-Negative was seen to have the strongest relationship across all SITB behaviors while Automatic-Negative was not found to be relatively low compared to other SITB behaviors. Both Social-Positive and Social-Negative were found to be present in moderate relationships compared to Automatic in general.