Pathological self-destructive behaviour and behaviour therapy: a review AbstractThe literature on pathological self-destructive behaviour (apart from psychotic, substance-induced or brain disorders) and behaviour therapy is reviewed.An introduction on definition, classification, current typological approaches, occurrence, pathogenesis, and psychopathology is given.From a behavioural theoretic perspective, functional aspects of self-destructive behaviour are emphasised.Basic treatment problems are outlined.They particularly concern covert self-destructive behaviour (artificial disease, Munchhausen-syndrome) that is typically met in a medical hospital setting.Recommendations from the literature are resumed. Most of the relevant publications are psychoanalytically based.Case reports on self-destructive patients predominate even in behaviour therapy publications.These are briefly reviewed.So far, the most elaborate approach is considered to be M.Linehan's Dialectic-Behavioral-Therapy which has been developed for the treatment of borderline personality disorders.A considerable overlap between overtly self-destructive patients and borderline patients underlines the usefulness of this approach.Nonetheless, a further development of behavioural therapeutic methods with regard to different types of self-destructive behaviour is considered to be indicated.
KeywordsSelf-destructive behaviour · Factitious disorder · Behaviour therapy · Review
PathogeneseErkenntnisse stammen aus kasuistischen Beobachtungen und kleinen Stichproben. Systematische Untersuchungen fehlen.Psychologische Erklärungsmodelle sind hauptsächlich psychoanalytisch