Anhedonic girls comprise an increasing group of nonfunctioning adolescent girls who complain of feeling empty or dead inside. Their most striking characteristic is a propensity for scratching or cutting their wrists. However, in contrast to wrist scratching in men or older women, this cutting is remarkably painless and is not suicidal.

The severe separation anxiety characteristic of these girls stimulates massive rage reactions, which result in depersonalization, both as a defense and as a result of a fragile self-representation. The suggestion is made that wrist scratching is a specific technique of dealing with both the rage and the depersonalization. The genetic basis of this disorder may be that the induced bleeding in the cutting is an attempt to undo the current separation by identifying with the bleeding woman (mother), symbolic of this mother-infant unity in the past.