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Cited by 1,979Suicide and Self-Harm StudiesPersonality Disorders and PsychopathologyHomicide, Infanticide, and Child Abuse

The functions of deliberate self-injury: a review of the evidence

Klonsky, E. David·2007·Clinical Psychology Review
DOI 10.1016/j.cpr.2006.08.002
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Abstract

Deliberate self-injury is defined as the intentional, direct injuring of body tissue without suicidal intent. The present article reviews the empirical research on the functions of self-injury. This literature includes self-reports of reasons for self-injuring, descriptions of the phenomenology of self-injury, and laboratory studies examining the effects of self-injury proxies on affect and physiological arousal. Results from 18 studies provide converging evidence for an affect-regulation function. Research indicates that: (a) acute negative affect precedes self-injury, (b) decreased negative affect and relief are present after self-injury, (c) self-injury is most often performed with intent to alleviate negative affect, and (d) negative affect and arousal are reduced by the performance of self-injury proxies in laboratory settings. Studies also provide strong support for a self-punishment function, and modest evidence for anti-dissociation, interpersonal-influence, anti-suicide, sensation-seeking, and interpersonal boundaries functions. The conceptual and empirical relationships among the different functions remain unclear. Future research should address the measurement, co-variation, clinical correlates, and treatment implications of different functions.

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  • A neurodevelopmental basis for emotional dysregulation could be in line with the transnosographic conceptualization of autism spectrum, which hypothesizes a possible neurodevelopmental underpinning for several psychiatric disorders.

    “A neurodevelopmental basis for ED could be in line with the transnosographic conceptualization of autism spectrum (39), which, on the basis of the frequent presence of autistic traits in different psychopathological conditions, hypothesizes a possible neurodevelopmental underpinning (whose autistic traits would be the phenotypical presentation) for several psychiatric disorders (40).”

    From Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood (2023) · cites this paper as [40]

  • The presence of a neurodevelopmental alteration would also feature a vulnerability towards life events, facilitating the development of trauma and stress related symptoms as well as a reduced ability to regulate emotions.

    “The presence of a neurodevelopmental alteration would also feature a vulnerability towards life events, facilitating the development of trauma and stress related symptoms as well as a reduced ability to regulate emotions (40).”

    From Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood (2023) · cites this paper as [40]

  • Previous research has identified that self-injury serves varied purposes, and an empirical review suggests the most common function is the regulation of negative affect.

    “Previous research has also identified that self-injury serves varied purposes, although an empirical review suggests the most common function is the regulation of negative affect (Klonsky, 2007).”

    From A multi‐method evaluation of a compassion‐focused cognitive behavioural psychotherapy group for people who self‐harm. (2022) · cites this paper as Klonsky, 2007

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Authors
Klonsky, E. D.
Affiliations
Stony Brook University (US)
Corresponding author
Klonsky, E. David
ORCID
Klonsky, E. David
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2007-03
Volume
27
Issue
2
Pages
226-239
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2006.08.002
OpenAlex
W2132656837
Cited by
1,979
References
77
Citations by year
2026: 144 · 2025: 151 · 2024: 107 · 2023: 155 · 2022: 126 · 2021: 114 · 2020: 104 · 2019: 102 · 2018: 103 · 2017: 112 · 2016: 93 · 2015: 125 · 2014: 95 · 2013: 115 · 2012: 100
FWCI
4.35
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Stony Brook University
  • National Institutes of Health
  • National Institute of Mental Health (F31MH067299, MH67299)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
functions of self-injury, emotion regulation, self-punishment, negative affect, physiological arousal, dissociation, interpersonal influence, sensation seeking, interpersonal boundaries, suicidal behavior
MeSH terms
Affective Symptoms, Arousal, Dissociative Disorders, Exploratory Behavior, Humans, Interpersonal Relations, Motivation, Punishment, Self Mutilation, Statistics as Topic, Suicide, Attempted, Self-Injurious Behavior

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