ABSTRACT
The neurobiology of self-harm is a field that has been developed significantly over the past 30 years. The aims of this work include to further our understanding of the biological mechanisms of self-harm, and to introduce the possibility of developing complementary biological risk assessment strategies and future therapeutic interventions. Self-harm occurs in a number of conditions; however, there is increasing evidence for certain characteristic neurobiological findings in self-harm independent of psychiatric diagnosis. Much of the literature examines ‘suicidal behaviour’, (which in the USA tends to include at least some intent to end one’s life, unlike in Europe),1
while some studies more specifically examine borderline personality disorder. The majority of the literature has looked at adult populations. The neurobiology of self-harm in young people is in a more embryonic stage, despite adolescence being noted as a period of significant vulnerability with respect to neurobiological development,2 and there being a growing literature in the developmental psychopathology of borderline personality disorder.3 Research methods comprise the use of animal models, in vivo and post-mortem studies of neurotransmitters, their metabolites, receptor binding, receptor density and second messenger systems, and more recently functional neuroimaging studies. Genetic studies are also contributing significantly to knowledge of the neurobiology of self-harm and are discussed in Chapter 3. More exciting recent developments are in elucidating the clinical endophenotypes of suicidal behaviour and their relationship to neurobiological findings, thus forming psychobiological hypotheses of self-harm.
