{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:09:02Z","timestamp":1793124542978,"version":"4.5.0"},"reference-count":43,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Forensic and Legal Medicine"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1016\/j.jflm.2026.103141","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T16:17:44Z","timestamp":1776701864000},"page":"103141","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["Extreme self injurious behavior in a state prison system: A mixed methods analysis of medically severe and bizarre events"],"prefix":"10.1016","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5000-5094","authenticated-orcid":false,"given":"Hayden P.","family":"Smith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jflm.2026.103141_bib1","first-page":"193","article-title":"Deliberate self-harm and suicide attempt in custody: distinguishing features in male prisoners","volume":"21","author":"Lohner","year":"2006","journal-title":"Eur Psychiatry"},{"key":"10.1016\/j.jflm.2026.103141_bib2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/0093854809348474","article-title":"Inmate self-injurious behaviors: distinguishing characteristics within a retrospective study","volume":"37","author":"Smith","year":"2010","journal-title":"Crim Justice Behav"},{"key":"10.1016\/j.jflm.2026.103141_bib3","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/0093854810385886","article-title":"Self-injurious behaviors in U.S. prisons: findings from a national survey","volume":"38","author":"Smith","year":"2011","journal-title":"Crim Justice Behav"},{"key":"10.1016\/j.jflm.2026.103141_bib4","first-page":"188","article-title":"Inmates who harm themselves: risk factors, behaviors, and outcomes","volume":"12","author":"Young","year":"2006","journal-title":"J Correct Health Care"},{"key":"10.1016\/j.jflm.2026.103141_bib5","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/1078345809331444","article-title":"Institutional responses to self-injurious behavior among inmates","volume":"15","author":"DeHart","year":"2009","journal-title":"J Correct Health Care"},{"key":"10.1016\/j.jflm.2026.103141_bib6","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1177\/1078345809348212","article-title":"Self-injurious behavior in correctional settings","volume":"16","author":"Fagan","year":"2010","journal-title":"J Correct Health Care"},{"key":"10.1016\/j.jflm.2026.103141_bib7","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1192\/bjp.bp.112.116111","article-title":"Non-suicidal self-injury v. attempted suicide: new diagnosis or false dichotomy?","volume":"202","author":"Kapur","year":"2013","journal-title":"Br J Psychiatry"},{"key":"10.1016\/j.jflm.2026.103141_bib8","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.cpr.2006.08.002","article-title":"The functions of deliberate self-injury: a review of the evidence","volume":"27","author":"Klonsky","year":"2007","journal-title":"Clin Psychol Rev"},{"key":"10.1016\/j.jflm.2026.103141_bib9","first-page":"78","article-title":"Why do people hurt themselves? New insights into the nature and functions of self-injury","volume":"17","author":"Nock","year":"2008","journal-title":"Curr Dir Psychol Sci"},{"key":"10.1016\/j.jflm.2026.103141_bib10","first-page":"313","article-title":"Background risk factors associated with parasuicide among male prison inmates","volume":"32","author":"Ivanoff","year":"2005","journal-title":"Crim Justice Behav"},{"key":"10.1016\/j.jflm.2026.103141_bib11","first-page":"476","article-title":"\u201cThe meaning of the cut\u201d: a phenomenological inquiry into prisoner self-injury","volume":"32","author":"Smith","year":"2015","journal-title":"Justice Q JQ"},{"key":"10.1016\/j.jflm.2026.103141_bib12","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/BF00755050","article-title":"The plight of chronic self-mutilators","volume":"24","author":"Favazza","year":"1988","journal-title":"Community Ment Health J"},{"key":"10.1016\/j.jflm.2026.103141_bib13","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/00005053-199805000-00001","article-title":"The coming of age of self-mutilation","volume":"186","author":"Favazza","year":"1998","journal-title":"J Nerv Ment Dis"},{"key":"10.1016\/j.jflm.2026.103141_bib14","first-page":"169","article-title":"Atypical and severe self-injurious behavior: an empirical review","volume":"230","author":"Hom","year":"2018","journal-title":"J Affect Disord"},{"key":"10.1016\/j.jflm.2026.103141_bib15","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1001\/archpsyc.1979.01780040083009","article-title":"Male genital self-mutilation","volume":"36","author":"Greilsheimer","year":"1979","journal-title":"Arch Gen Psychiatry"},{"key":"10.1016\/j.jflm.2026.103141_bib16","first-page":"54","article-title":"Intentional ingestion and insertion of foreign objects by a forensic population","volume":"18","author":"Klein","year":"2012","journal-title":"J Psychiatr Pract"},{"key":"10.1016\/j.jflm.2026.103141_bib17","first-page":"281","article-title":"Long-term and bizarre self-injurious behaviour: a case report","volume":"67","author":"Navin\u00e9s","year":"2013","journal-title":"Psychiatr Clin Neurosci"},{"issue":"5","key":"10.1016\/j.jflm.2026.103141_bib39","first-page":"470","article-title":"Self-inflicted eye injuries: case presentations and a literature review","volume":"45","author":"Kennedy","year":"1994","journal-title":"Hosp Community Psychiatry"},{"key":"10.1016\/j.jflm.2026.103141_bib18","first-page":"136","article-title":"A survey of self-injury in a women's prison","volume":"131","author":"Cookson","year":"1977","journal-title":"Br J Psychiatry"},{"key":"10.1016\/j.jflm.2026.103141_bib19","series-title":"Suicide Attempts and self-injury in Male Prisons","author":"Liebling","year":"1993"},{"key":"10.1016\/j.jflm.2026.103141_bib20","first-page":"345","article-title":"Are \u201cthe worst of the worst\u201d self-injurious prisoners more likely to end up in long-term maximum-security settings?","volume":"21","author":"Lanes","year":"2011","journal-title":"Crim Behav Ment Health"},{"key":"10.1016\/j.jflm.2026.103141_bib21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/1068316X.2022.2127716","article-title":"Re-examining the dual-harm profile in prison","volume":"30","author":"Slade","year":"2024","journal-title":"Psychol Crime Law"},{"key":"10.1016\/j.jflm.2026.103141_bib22","first-page":"129","article-title":"Self-inflicted injury and coping behaviours in prison","volume":"31","author":"Dear","year":"2000","journal-title":"J Offender Rehabil"},{"key":"10.1016\/j.jflm.2026.103141_bib23","first-page":"489","article-title":"A grounded theory exploration of deliberate self-harm in women","volume":"29","author":"Mangnall","year":"2008","journal-title":"Issues Ment Health Nurs"},{"key":"10.1016\/j.jflm.2026.103141_bib24","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1525\/fsr.2011.24.1.46","article-title":"Prisons within prisons: the use of segregation in the United States","volume":"24","author":"Browne","year":"2011","journal-title":"Fed Sentencing Report"},{"key":"10.1016\/j.jflm.2026.103141_bib25","first-page":"1","article-title":"Restrictive housing and its association with self-injury among men in prison","volume":"3","author":"Labrecque","year":"2018","journal-title":"Corrections"},{"key":"10.1016\/j.jflm.2026.103141_bib26","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1177\/0093854808318584","article-title":"Patterns of disturbed behavior in a supermax population","volume":"35","author":"Lovell","year":"2008","journal-title":"Crim Justice Behav"},{"issue":"1","key":"10.1016\/j.jflm.2026.103141_bib40","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/0011128702239239","article-title":"Mental health issues in long\u2011term solitary and \u201csupermax\u201d confinement","volume":"49","author":"Haney","year":"2003","journal-title":"Crime Delinq"},{"issue":"8","key":"10.1016\/j.jflm.2026.103141_bib41","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1177\/0093854808318591","article-title":"What to do with the survivors? Coping with the long-term effects of isolated confinement","volume":"35","author":"Kupers","year":"2008","journal-title":"Crim Justice Behav"},{"key":"10.1016\/j.jflm.2026.103141_bib27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/cbm.2103","article-title":"Working with prisoners who self-harm: a qualitative study on stress, denial of weakness, and encouraging resilience in a sample of correctional staff","volume":"29","author":"Smith","year":"2019","journal-title":"Criminal Behavior and Mental Health"},{"issue":"1","key":"10.1016\/j.jflm.2026.103141_bib28","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1080\/1478601X.2015.1112284","article-title":"What to do with the cutters? Best practices for offender self-injurious behaviors","volume":"29","author":"Power","year":"2016","journal-title":"Crim Justice Stud"},{"issue":"1","key":"10.1016\/j.jflm.2026.103141_bib42","first-page":"69","article-title":"Self-mutilation and suicide attempt: distinguishing features in prisoners","volume":"25","author":"Fulwiler","year":"1997","journal-title":"J. Am. Acad. Psychiatry Laww"},{"key":"10.1016\/j.jflm.2026.103141_bib29","series-title":"A Qualitative Analysis of self-injurious Behavior in Corrections (Doctoral Dissertation)","author":"Doty","year":"2012"},{"key":"10.1016\/j.jflm.2026.103141_bib30","first-page":"63","article-title":"Self-harm in Western Australian prisons: an examination of social and psychological correlates","volume":"34","author":"Dear","year":"2001","journal-title":"Aust N Z J Criminol"},{"key":"10.1016\/j.jflm.2026.103141_bib43","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1177\/0306624X14552063","article-title":"Self-injurious behavior in prison: A case study","volume":"60","author":"Smith","year":"2016","journal-title":"Int. J. Offender Ther. Comp. Criminol."},{"key":"10.1016\/j.jflm.2026.103141_bib31","first-page":"145","article-title":"Non-suicidal self-injury and co-occurring suicide attempts: a meta-analysis","volume":"49","author":"Favril","year":"2019","journal-title":"Psychol Med"},{"key":"10.1016\/j.jflm.2026.103141_bib32","first-page":"170","article-title":"Psychiatric aspects of male genital self-mutilation","volume":"24","author":"Martin","year":"1991","journal-title":"Psychopathology"},{"key":"10.1016\/j.jflm.2026.103141_bib33","first-page":"1","article-title":"The mentally disordered inmate and the law","volume":"27","author":"Cohen","year":"2003","journal-title":"Law & Psychiatry"},{"key":"10.1016\/j.jflm.2026.103141_bib34","first-page":"98","article-title":"Preventing self-harm and suicide in prisons: a systematic review of interventions","volume":"24","author":"Forrester","year":"2014","journal-title":"Crim Behav Ment Health"},{"key":"10.1016\/j.jflm.2026.103141_bib35","series-title":"Ill-Equipped: U.S. Prisons and Offenders with Mental Illness","year":"2003"},{"key":"10.1016\/j.jflm.2026.103141_bib36","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1037\/ccp0000214","article-title":"Outcomes of psychological therapies for prisoners with mental health problems: a systematic review and meta-analysis","volume":"85","author":"Yoon","year":"2017","journal-title":"J Consult Clin Psychol"},{"key":"10.1016\/j.jflm.2026.103141_bib37","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1176\/appi.ajp.2008.08030416","article-title":"Psychiatric disorders and repeat incarcerations: the revolving prison door","volume":"166","author":"Baillargeon","year":"2009","journal-title":"Am J Psychiatr"},{"key":"10.1016\/j.jflm.2026.103141_bib38","first-page":"CD013421","article-title":"Interventions to reduce self-harm and suicide in prisons: a systematic review","volume":"3","author":"Witt","year":"2021","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Journal of Forensic and Legal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1752928X26000739?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1752928X26000739?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:30:38Z","timestamp":1788535838000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1752928X26000739"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":43,"alternative-id":["S1752928X26000739"],"URL":"https:\/\/doi.org\/10.1016\/j.jflm.2026.103141","relation":{"has-version":[{"id-type":"doi","id":"10.21428\/cb6ab371.a483e3bb","asserted-by":"object"}]},"ISSN":["1752-928X"],"issn-type":[{"value":"1752-928X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Extreme self injurious behavior in a state prison system: A mixed methods analysis of medically severe and bizarre events","name":"articletitle","label":"Article Title"},{"value":"Journal of Forensic and Legal Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jflm.2026.103141","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"103141"}}