A psychological perspective on dermatitis artefacta, skin picking and other self-injurious behaviors

Résumé

One-third of young patients seen for dermatologic problems also present with co-morbid psychiatric/psychological problems. These youth are vulnerable to chronic self-injurious behavior; in severe cases, they are at risk for suicidal behavior. The majority of youth who self-injure do not intend to commit suicide. Instead, they use their self-injurious behavior as a non-verbal form of communication. Dermatitis artefacta (also called factitious dermatitis or factitious skin disorder) is the deliberate self-harm (DSH) of the tissue of one's own body tissue such as cutting, carving, skin- picking [SP], other self-injurious behaviors: self-mutilation [SMB]). The psychological literature employs some of the same terms but includes some slightly different terms: self-destructive behavior, self-injurious behavior (SIB), and non-suicidal self-injurious behavior (NSSI). This paper focuses on understanding and treating NSSI and include information that is general and specific to dermatitis artefacta, skin picking, and other self-injurious behaviors. NSSI is often a chronic problem that is associated and comorbid with affective disorders and sometimes with psychosis. Empirically supported treatments (EST) for children and adolescents who engage in NSSI are behavior therapy (BT), cognitive behavior therapy (CBT), and interpersonal behavior therapy (IPT). Teamwork is essential for effective treatment. Referring physicians should serve as the team leader of the medical home and employ consultants as treatment team members; this may include other medical specialists (dermatology and psychiatry), psychologists, social workers, occupational therapist (for youth with tactile issues), parents, and the patient/client. (PsycINFO Database Record (c) 2015 APA, all rights reserved) AUTO-MUTILATION COMPORTEMENT-AUTODESTRUCTEUR NON-SUICIDAIRE