Self-punishment is related to dangerous, destructive behaviors, also called self-mutilation, para-suicidal gestures, or self-harm. These behaviors can occur in individuals who are depressed or anxious, lack alternative coping skills, or need attention and nurturing. Also, those who experience great loneliness, emptiness, and perceived deprivation often engage in self-destructive behaviors. All of these factors are common for people suffering from an eating disorder, putting them at greater risk for engaging in self-injurious acts. In addition to starving themselves or purging, people with eating disorders may purposely try to harm themselves by cutting or burning themselves, picking at wounds, pulling their hair, banging their head, trying to break their bones, or engaging in high-risk "extreme" behaviors.