Self-injurious behavior in women with eating disorders

Am J Psychiatry. 2002 Mar;159(3):408-11. doi: 10.1176/appi.ajp.159.3.408.


Objective: The authors assessed lifetime and 6-month occurrence and phenomenology of self-injurious behavior in patients with eating disorders.

Method: Women (N=376) in inpatient treatment for an eating disorder (anorexia: N=119, bulimia: N=137, eating disorder not otherwise specified: N=120) were assessed for self-injurious behavior and completed the Traumatic Life Events Questionnaire, the Dissociative Experience Scale, the Barratt Impulsiveness Scale, and the Yale-Brown Obsessive Compulsive Scale.

Results: The lifetime rate of self-injurious behavior occurrence was 34.6%, with the highest rates found in subjects with eating disorder not otherwise specified (35.8%) and bulimia (34.3%); the 6-month rate of self-injurious behavior occurrence was 21.3%. Multivariate comparisons were computed for the factors of self-injurious behavior and diagnostic subgroup: self-injuring patients reported a significantly higher number of traumatic events, showed significantly higher dissociation scores, and exhibited significantly more obsessive-compulsive thoughts and behaviors. Bulimic patients showed significantly higher impulsivity scores.

Conclusions: This study strongly supports the assumption that patients with eating disorders are at risk for self-injurious behavior and points to the necessity of a routine screening for self-injurious behavior as well as the development of a standardized questionnaire. Group comparisons point to the relevance of traumatic experiences and comorbid dissociative phenomenology.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anorexia Nervosa / diagnosis
  • Anorexia Nervosa / epidemiology
  • Anorexia Nervosa / psychology
  • Bulimia / diagnosis
  • Bulimia / epidemiology
  • Bulimia / psychology
  • Child
  • Child Abuse, Sexual / diagnosis
  • Child Abuse, Sexual / psychology
  • Child Abuse, Sexual / statistics & numerical data
  • Comorbidity
  • Dissociative Disorders / diagnosis
  • Dissociative Disorders / epidemiology
  • Dissociative Disorders / psychology
  • Feeding and Eating Disorders / diagnosis
  • Feeding and Eating Disorders / epidemiology*
  • Feeding and Eating Disorders / psychology
  • Female
  • Hospitalization
  • Humans
  • Impulsive Behavior / diagnosis
  • Impulsive Behavior / epidemiology
  • Impulsive Behavior / psychology
  • Life Change Events
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / psychology
  • Prevalence
  • Psychiatric Status Rating Scales
  • Psychometrics
  • Self-Injurious Behavior / diagnosis
  • Self-Injurious Behavior / epidemiology*
  • Self-Injurious Behavior / psychology
  • Sex Factors
  • Surveys and Questionnaires