Adolescent Self-Mutilating Behaviors: Experiential Avoidance Coupled with Imitation? Page: 11
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her thighs. Although she was bleeding, her husband scorned her. As ever,
he thought she was faking her problems.
- Andrew Morton on Princess Diana
Peers, Contagion, and RSM
Social acceptability, competition, and peer influence appear to be important components
in the instigation and repetition of adolescent self-mutilation. Early descriptions of
institutionalized "wrist-slashers" indicate that such individuals may cluster as a social group, and
form a strong, long-lasting group identification as "cutters." As early as the 1960s, Grunebaum
and Klerman (1967) refer to "co-conspiratorial dyads" between two individuals who treat wrist
cutting as a form of bonding, as well as a form of competition. There may be competition to be
the "chief cutter" and to prove themselves as the most unhappy on the inpatient treatment ward
(Graff & Mailin, 1967; Grunebaum & Klerman, 1967; Rosen & Walsh, 1989).
These findings are consistent with more recent observations that self-mutilative acts are
often "clustered" in time, indicating that RSM behavior in others may trigger RSM among
repeaters, or even an initiation of self-mutilation among previously naive individuals (Taiminen
et al., 1998; Walsh & Rosen, 1985). Individuals who do not engage in such behavior before
inpatient admission may first learn this behavior from fellow patients. Among a small sample of
inpatient adolescents, approximately half of the patients began to self-cut for the first time while
in the hospital (Ghaziuddin, Tsai, Naylor, & Ghaziuddin, 1992). Gardner and Gardner (1975)
reported a similar finding, in that 14 of 22 non-psychotic female self-cutters in their study
engaged in their first episode of self cutting after inpatient admission.
This behavior is evident beyond institutionalized and inpatient youth. Anecdotal accounts
by a school counselor, teacher, and youth minister who work regularly with adolescents indicate
that RSM is becoming more common among middle and high school students. These students11
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Howe-Martin, Laura S. Adolescent Self-Mutilating Behaviors: Experiential Avoidance Coupled with Imitation?, dissertation, August 2008; Denton, Texas. (https://digital.library.unt.edu/ark:/67531/metadc9087/m1/20/: accessed April 24, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; .