The treatment of self-injury, or self-destruction of one's own body tissue, has become a new focus for both researchers and clinicians. Traditionally, the field of self-injury has distinguished between the behaviors exhibited among individuals with a developmental disability (self-injurious behaviors [SIBs]) and those present within a normative population (nonsuicidal self-injury [NSSI]). Despite this distinction, many pharmacotherapies for self-injury have been administered for both populations. The current review begins by summarizing the available efficacy studies investigating common pharmacological interventions in the treatment of self-injury. These studies are organized based on the most empirically supported neurochemical pathways in the development or maintenance of NSSI: endogenous opiods and monoamines. Although significant advances have been made in the field, conclusions based on efficacy studies of the pharmacological interventions used in the treatment of self-injury have been somewhat inconsistent. Finally, the review includes a discussion about potential avenues in the pharmacological treatment of NSSI via animal models of self-injury. Animal models present a unique opportunity to test neurobiological theories of self-injury using a controlled, systematic approach. Clinical considerations are presented as they relate to the available research findings and best practices in the treatment of self-injury.
Current findings provide evidence for caution in the development of pharmacotherapies of NSSI in human populations based on CNS stimulant models. Theoretical implications are discussed with respect to antecedent factors such as preinjury arousal level and environmental stress.
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