Self Harm and Substance Use

The tendency to react to painful internal states with harmful behaviors contributes to the agony that is felt by family and friends of those struggling with symptoms of depression, anxiety, and unstable moods. Behaviors can include self harm, alcohol and drug use, risky behaviors, and others.


Self-harming and dysfunctional behaviors decreased from extremely high to close to average.

On admission, participants reported an extreme level of dysfunctional behaviors (mean = 88.38, SD 19.29). After initial treatment phase, these behaviors were close to the average range (mean = 57.03, SD 11.63). Above 70 is considered clinically significant. The average level of these behaviors in the general population is measured at T=50.

Dysfunctional behaviors are measured with the Tension Reduction Activities scale of John Briere's IASC (2000).


Self harm and risky behaviors decreased from 5.55 per week to less than 1 risky behavior weekly.

Similar behaviors were also measured on Marsha Linehan's BSL-23. On admission, participants reported an average of 5.55 (SD = 5.27) of these behaviors in the week before starting treatment. After initial treatment phase, these behaviors had decreased to an average of less than one weekly (SD = 2.36). Self-harm behaviors were eliminated.