자해자에 대한 정신의학적 조사

A Psychiatric Investigation of the Self-Injured

The authors attempted at an evaluation of the clinical characteristics of the self-injured adolescents. Entered in this investigation were 200 male draftees of Korean Army from Seoul and its vicinity, who had been referred to the neuropsychiatric department for a more intensive neuropsychiatric evaluation due to their scars of apparently self-inflicted injuries during the period from Feb. to June, 1979. A control group of 218 males was extracted from the same band of draftees, who did not have any appreciable scars on their bodies. Age of the self-injured ranged from 20 to 25 years. Their educational level was lower than the nonself-injured group and they were more often unemployed. Personality disorders occupied 62. 5% of the self-injured group, most of them representing the delinquents, such as antisocial, borderline, passive-aggressive or explosive personalities. Next in order of frequencies were neurotic disorders (18. 5%)，and schizophrenic disorders (6.0%). It was noted that no one was given the diagnosis of affective psychoses. This pattern of diagnostic distribution, together with their more frequent parental loss and a high rate of previous criminal history, indicates that most of the group of selfinjured represents the so called delinquents. Their motivation for the act of the self-injury was different from that expected in a suicidal behavior of the typical depressives. They were mostly gestures with certain secondary gains in the presence of others and a motive of a tension relief was seen in the fact that about two thirds of them experienced a complete relief of tension during and immediately after the self-injury. It was also shown that they had been unable to discharge their aggression and anger directed towards others which they turned against them- selves with the help of alcohol, a disinhibitor Means of each scales of the MM PI showed that all the scales except L and K were significantly higher in the self-injured group, and the pattern of the mean scores of the group revealed F-8-9- 4-6-7 type profile, also indicating indirectly that they represent a delinquent group.