Materiały źródłowe

• #1 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6959491/

  Nonsuicidal self-injury (NSSI) involves deliberate and intentional injury to body tissue that occurs in the absence of suicidal intent. Typical examples here might include self-cutting, burning, or self-hitting. […] Much has changed over time, culminating in the entry of NSSI Disorder into DSM-5 as a condition in need of further study. In this review we describe the evolution of the NSSI construct and consider current issues in its diagnosis and assessment. […] For a behavior to be classified as NSSI (according to both Favazza’s definition and the DSM-5 diagnostic criteria) it must be intentional and deliberate. […] As we have noted and as the name itself suggests, NSSI must also be nonsuicidal. […] NSSI must be distinguished from the stereotypic self-injury that occurs in many developmental disorders.

• #2 The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature | Child and Adolescent Psychiatry and Mental Health | Full Text

  https://capmh.biomedcentral.com/articles/10.1186/s13034-015-0062-7

  With the presentation of nonsuicidal self-injury disorder (NSSID) criteria in the fifth version of the Statistical and Diagnostic Manual of Mental Disorders (DSM-5), empirical studies have emerged where the criteria have been operationalized on samples of children, adolescents and young adults. […] Results showed preliminary support for a distinct and independent NSSID diagnosis, but additional empirical data are needed with direct and structured assessment of the final DSM-5 criteria in order to reliably assess and validate a potential diagnosis of NSSID. […] The NSSI criteria were finally placed in Section III of DSM-5: Emerging Measures and Models, as a condition that requires further study, due to lack of reliability in the clinical trial. […] A total of 16 published studies were found that presented empirical data on NSSID.

• #3 What Is Cutting and What Are the Warning Signs? | Self-Harm

  https://www.hhills.com/rehab-blog/what-is-cutting-and-what-are-the-warning-signs/

  Non-suicidal self-injury—often referred to as self-harm—involves any act of intentionally injuring or causing harm to oneself. […] While self-harm can take on various forms, Mental Health America reports that 70–90% of people who self-harm choose cutting as their preferred method. […] Self-harm is not a mental health disorder but rather a symptom of an underlying issue(s). […] Without professional intervention, individuals who self-harm become stuck in a vicious cycle that can lead to long-term issues, including an increased risk of suicide. […] Harmony Hills offers a self-harm treatment program to help uncover and address the problems contributing to self-harming behaviors while teaching healthy coping mechanisms to help break the cycle. […] If you suspect someone you know is cutting, look for these common signs: Symptoms of depression, a decline in daily functioning, inability to maintain stable relationships, expression of feelings of low self-worth, hopelessness, or helplessness, keeping sharp objects on hand, frequent reports of accidental injuries, wearing long pants and long sleeves, even in hot weather, fresh cuts, scratches, or wounds.

• #4 The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature | Child and Adolescent Psychiatry and Mental Health | Full Text

  https://capmh.biomedcentral.com/articles/10.1186/s13034-015-0062-7

  With the presentation of nonsuicidal self-injury disorder (NSSID) criteria in the fifth version of the Statistical and Diagnostic Manual of Mental Disorders (DSM-5), empirical studies have emerged where the criteria have been operationalized on samples of children, adolescents and young adults. […] Results showed preliminary support for a distinct and independent NSSID diagnosis, but additional empirical data are needed with direct and structured assessment of the final DSM-5 criteria in order to reliably assess and validate a potential diagnosis of NSSID. […] The NSSI criteria were finally placed in Section III of DSM-5: Emerging Measures and Models, as a condition that requires further study, due to lack of reliability in the clinical trial. […] A total of 16 published studies were found that presented empirical data on NSSID.

• #5 The surprising place for self-injury in the new DSM-5 | Self Injury Institute

  https://selfinjuryinstitute.com/the-surprising-place-for-self-injury-in-dsm-5/

  The fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) is out this month. […] We at KISI were disappointed to find Non-Suicidal Self-Injury, a diagnosis we fully expected to be part of DSM-5, relegated to the back of the book, in a section on Conditions for Further Study. It isnt available as a formal diagnosis. […] For now, though, there actually is a diagnostic code that practitioners can use when self-injury is the focus of treatment. […] Personal history of self-harm (V15.59) is a new diagnostic category listed in what are called the V-codes. These diagnoses are not considered mental illnesses in and of themselves, but rather are other conditions or problems that may be a focus of clinical attention or that may otherwise affect the diagnosis, course, prognosis, or treatment of a patients mental disorder.

• #6 The surprising place for self-injury in the new DSM-5 | Self Injury Institute

  https://selfinjuryinstitute.com/the-surprising-place-for-self-injury-in-dsm-5/

  The fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) is out this month. […] We at KISI were disappointed to find Non-Suicidal Self-Injury, a diagnosis we fully expected to be part of DSM-5, relegated to the back of the book, in a section on Conditions for Further Study. It isnt available as a formal diagnosis. […] For now, though, there actually is a diagnostic code that practitioners can use when self-injury is the focus of treatment. […] Personal history of self-harm (V15.59) is a new diagnostic category listed in what are called the V-codes. These diagnoses are not considered mental illnesses in and of themselves, but rather are other conditions or problems that may be a focus of clinical attention or that may otherwise affect the diagnosis, course, prognosis, or treatment of a patients mental disorder.

• #7 Self-Harm & Eating Disorders

  https://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring-dual-diagnosis/self-injury

  The ICD-10 code for non-suicidal self-injury is Z91.5. […] As the motivations behind engaging in both eating disorders and self-injurious behaviors are similar, treatment of one is often similar to, and will support, treatment of the other. […] Therapy can provide key behavioral support for eating disorders and self-harming recovery, as therapy will teach the individual how to alter their cognitions and strengthen and use their skills in order to more effectively cope with distress.

• #8 2025 ICD-10-CM Diagnosis Code R45.88: Nonsuicidal self-harm

  https://www.icd10data.com/ICD10CM/Codes/R00-R99/R40-R46/R45-/R45.88

  R45.88 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. […] Applicable To: Nonsuicidal self-injury, Nonsuicidal self-mutilation, Self-inflicted injury without suicidal intent. […] Self-injury, nonsuicidal R45.88. […] Self-mutilation (attempted) nonsuicidal R45.88.

• #9 Suicide and Intentional Self-Harm Deaths and Hospitalizations

  https://www.flhealthcharts.gov/charts/OpenPage.aspx?tn=660

  Suicide is death caused by injuring oneself with the intent to die. […] Intentional self-harm is injury or poisoning inflicted on oneself by deliberate means with the intent to harm oneself or with the intent to take one’s own life. Not all intentional self-harm injuries are suicide attempts. […] Intentional self-harm ICD-10-CM Code(s): T14.91, T36-T50 with 6th character of 2, T36.9/T37.9/T39.9/T41.4/T42.7/T43.9/T45.9/T47.9/T49.9 with 5th character of 2, T51-T65 with 6th character of 2, T51.9/T52.9/T53.9/T54.9/T56.9/T57.9/T58.0/T58.1/T58.9/T59.9/T60.9/T61.0/T61.1/T61.9/T62.9/T63.9/T64.0/T64.8/T65.9 with 5th character of 2, T71 with 6th character of 2, X71-X83 as any diagnosis or external cause of injury. […] Intentional self-harm by cut / pierce ICD-10-CM Code(s): X78 as any diagnosis or external cause of injury.

• #10 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6959491/

  The construct of NSSI has gained widespread acceptance in the USA, Europe, Australia, and many other parts of the world. […] By definition, NSSI must occur in the absence of suicidal intent. Yet NSSI can hardly be considered entirely nonsuicidal. […] NSSI is not the only way that people can hurt themselves. […] NSSI requires direct and intentional infliction of harm, and the harm inflicted must occur immediately after the behavior itself. […] A key issue, however, is whether the threshold of five NSSI days in the past year is too low to meaningfully differentiate between clinical and subclinical groups of people who engage in NSSI. […] Criterion A concerns the frequency and duration of NSSI. More specifically, to meet the criterion, intentional self-inflicted damage must have occurred on 5 or more days over the past year.

• #11 Self-injury (Cutting, Self-Harm or Self-Mutilation) | Mental Health America

  https://www.mhanational.org/conditions/self-injury-cutting-self-harm-or-self-mutilation

  The diagnosis for someone who self-injures can only be determined by a medical or mental health professional. Self-injury behaviors can be a symptom other mental illnesses, such as: personality disorders, bipolar disorder, depression, anxiety disorders, obsessive-compulsive disorder, and psychotic disorders, such as schizophrenia. […] Criteria for a Diagnosis of Non-Suicidal Self-Injury: Intentional self-inflicted damage to the surface of the body with expectation of physical harm, but without suicidal intent, for five or more days within the past year. […] The behavior can’t be explained by another mental, developmental, or other medical condition.

• #12 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6959491/

  Criterion B of NSSI-D in the DSM-5 requires that individuals engage in NSSI for one or more of the following reasons: (1) to obtain relief from a negative feeling or cognitive state, (2) to resolve an interpersonal difficulty, or (3) to induce a positive feeling state. […] The C Criterion of DSM-5 highlights the thoughts or mood states that are required to accompany self-injurious behavior. […] The D criterion is useful, however, because it creates boundary conditions and formally excludes socially sanctioned behaviors such as body piercing. […] The F Criterion clarifies the contexts where this is the case. […] With respect to NSSI, however, this is potentially problematic. […] In recent years, several interview-based and self-report measures have been developed to assess NSSI. […] Most NSSI assessments predate the entry of NSSI-D into the DSM-5 as a condition for further study. […] The addition of NSSI-D into the DSM represents a major step forward for research in this area. […] Despite these challenges, we agree with Selby et al and also with Brausch that recognizing NSSI-D brings with it many advantages.

• #13 Diagnosing self-harm cases | Hospital Clínic Barcelona

  https://www.clinicbarcelona.org/en/assistance/be-healthy/self-harm/diagnosis

  The diagnosis of self-harm is based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): On at least five days in the last year, the person has injured themselves in order to hurt themselves but not with the intention of suicide. […] The person self-harms for one or more of the following reasons: Relief from a negative feeling or thought. Resolving an interpersonal difficulty. Causing positive feelings. […] Before self-harming, the person experiences: Interpersonal difficulties or negative feelings or thoughts, including depression or anxiety. Frequent thoughts about self-harm. A frequent need to self-harm. […] The behaviour is not socially accepted (for example, getting piercings or tattoos, picking a scab or biting your nails are not considered to be self-harm). The behaviour causes distress or interferes with social, academic, or other important areas of functioning. The behaviour cannot be explained by any other mental disorder, neurodevelopmental disorder or other medical problem.

• #14 Diagnosing self-harm cases | Hospital Clínic Barcelona

  https://www.clinicbarcelona.org/en/assistance/be-healthy/self-harm/diagnosis

  The diagnosis of self-harm is based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): On at least five days in the last year, the person has injured themselves in order to hurt themselves but not with the intention of suicide. […] The person self-harms for one or more of the following reasons: Relief from a negative feeling or thought. Resolving an interpersonal difficulty. Causing positive feelings. […] Before self-harming, the person experiences: Interpersonal difficulties or negative feelings or thoughts, including depression or anxiety. Frequent thoughts about self-harm. A frequent need to self-harm. […] The behaviour is not socially accepted (for example, getting piercings or tattoos, picking a scab or biting your nails are not considered to be self-harm). The behaviour causes distress or interferes with social, academic, or other important areas of functioning. The behaviour cannot be explained by any other mental disorder, neurodevelopmental disorder or other medical problem.

• #15 Understanding Self-Injury/ Self-Harm – Mental Health Literacy

  https://mentalhealthliteracy.org/understanding-self-injury-self-harm/

  (Note): The absence of suicidal intent has either been stated by the individual or can be inferred by the individual’s repeated engagement in a behaviour that the individual knows, or has learned, is not likely to result in death. […] The individual engages in the self-injurious behaviour with one or more of the following expectations: […] To obtain relief from a negative feeling or cognitive state. […] To resolve an interpersonal difficulty. […] To induce a positive feeling state. […] (Note): The desired relief or response is experienced during or shortly after the self-injury, and the individual may display patterns of behaviour suggesting a dependence on repeatedly engaging in it. […] The intentional self-injury is associated with at least one of the following: […] Interpersonal difficulties or negative feelings or thoughts, such as depression, anxiety, tension, anger, generalized distress, or self-criticism, occurring in the period immediately prior to the self-injurious act.

• #16 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6959491/

  Criterion B of NSSI-D in the DSM-5 requires that individuals engage in NSSI for one or more of the following reasons: (1) to obtain relief from a negative feeling or cognitive state, (2) to resolve an interpersonal difficulty, or (3) to induce a positive feeling state. […] The C Criterion of DSM-5 highlights the thoughts or mood states that are required to accompany self-injurious behavior. […] The D criterion is useful, however, because it creates boundary conditions and formally excludes socially sanctioned behaviors such as body piercing. […] The F Criterion clarifies the contexts where this is the case. […] With respect to NSSI, however, this is potentially problematic. […] In recent years, several interview-based and self-report measures have been developed to assess NSSI. […] Most NSSI assessments predate the entry of NSSI-D into the DSM-5 as a condition for further study. […] The addition of NSSI-D into the DSM represents a major step forward for research in this area. […] Despite these challenges, we agree with Selby et al and also with Brausch that recognizing NSSI-D brings with it many advantages.

• #17 Understanding Self-Injury/ Self-Harm – Mental Health Literacy

  https://mentalhealthliteracy.org/understanding-self-injury-self-harm/

  Prior to engaging in the act, a period of preoccupation with the intended behaviour that is difficult to control. […] Thinking about self-injury that occurs frequently, even when it is not acted upon. […] The behaviour is not socially sanctioned (e.g., body piercing, tattooing, part of a religious or cultural ritual) and is not restricted to picking a scab or nail biting. […] The behaviour or its consequences cause clinically significant distress or interference in interpersonal, academic, or other important areas of functioning. […] The behaviour does not occur exclusively during psychotic episodes, delirium, substance intoxication, or substance withdrawal. […] In individuals with a neurodevelopmental disorder, the behaviour is not part of a pattern of repetitive stereotypies. […] The behaviour is not better explained by another mental disorder or medical condition (e.g., psychotic disorder, autism spectrum disorder, intellectual disability, Lesch-Nyhan syndrome, stereotypic movement disorder with self-injury, trichotillomania [hair-pulling disorder], excoriation [skin-picking] disorder).

• #18 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6959491/

  Criterion B of NSSI-D in the DSM-5 requires that individuals engage in NSSI for one or more of the following reasons: (1) to obtain relief from a negative feeling or cognitive state, (2) to resolve an interpersonal difficulty, or (3) to induce a positive feeling state. […] The C Criterion of DSM-5 highlights the thoughts or mood states that are required to accompany self-injurious behavior. […] The D criterion is useful, however, because it creates boundary conditions and formally excludes socially sanctioned behaviors such as body piercing. […] The F Criterion clarifies the contexts where this is the case. […] With respect to NSSI, however, this is potentially problematic. […] In recent years, several interview-based and self-report measures have been developed to assess NSSI. […] Most NSSI assessments predate the entry of NSSI-D into the DSM-5 as a condition for further study. […] The addition of NSSI-D into the DSM represents a major step forward for research in this area. […] Despite these challenges, we agree with Selby et al and also with Brausch that recognizing NSSI-D brings with it many advantages.

• #19 Self-injury (Cutting, Self-Harm or Self-Mutilation) | Mental Health America

  https://www.mhanational.org/conditions/self-injury-cutting-self-harm-or-self-mutilation

  The diagnosis for someone who self-injures can only be determined by a medical or mental health professional. Self-injury behaviors can be a symptom other mental illnesses, such as: personality disorders, bipolar disorder, depression, anxiety disorders, obsessive-compulsive disorder, and psychotic disorders, such as schizophrenia. […] Criteria for a Diagnosis of Non-Suicidal Self-Injury: Intentional self-inflicted damage to the surface of the body with expectation of physical harm, but without suicidal intent, for five or more days within the past year. […] The behavior can’t be explained by another mental, developmental, or other medical condition.

• #20 Self-injury/cutting | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/self-injurycutting

  Although some people may ask for help, sometimes family or friends discover the self-injury. Or a health care provider doing a routine medical exam may notice signs, such as scars or fresh injuries. […] There’s no specific test to diagnose self-injury. Diagnosis is based on a physical and psychological evaluation. You may be referred to a mental health professional with experience in treating self-injury for evaluation. This professional talks to you about your life, thoughts, feelings and behaviors. […] A mental health professional also may evaluate you for other mental health conditions that could be linked to self-injury, such as depression or personality disorders.

• #21 Self-injury/cutting – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/self-injury-cutting/

  Nonsuicidal self-injury, often simply called self-injury, is the act of deliberately harming your own body, such as cutting or burning yourself. […] Although some people may ask for help, sometimes self-injury is discovered by family members or friends. Or a doctor doing a routine medical exam may notice signs, such as scars or fresh injuries. […] There’s no diagnostic test for self-injury. Diagnosis is based on a physical and psychological evaluation. You may be referred to a mental health professional with experience in treating self-injury for evaluation. […] A mental health professional may also evaluate you for other mental health disorders that may be linked to self-injury, such as depression or personality disorders. If that’s the case, evaluation may include additional tools, such as questionnaires or psychological tests.

• #22 Self-Harm: What It Is, Causes, Types & Treatment

  https://my.clevelandclinic.org/health/diseases/12201-self-harm

  Self-injury is when you injure yourself on purpose. Also known as nonsuicidal self-injury disorder, people who self-harm do things to hurt themselves but don’t want to cause death. […] Nonsuicidal self-injury disorder can be difficult to diagnose. People who self-harm tend to hide their injuries and avoid talking about them. […] Healthcare providers don’t use a specific test to diagnose self-harm. Instead, they inspect your injuries, looking for patterns and scars from previous self-harm. […] If you see a healthcare provider about self-harm, they’ll first treat your injuries if needed. Longer term, they may recommend therapy and/or medications to help manage underlying mental health conditions and life stressors. […] Getting treatment for self-harm is important because it has several potential short- and long-term risks.

• #23 Self-injury/cutting | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/self-injurycutting

  Although some people may ask for help, sometimes family or friends discover the self-injury. Or a health care provider doing a routine medical exam may notice signs, such as scars or fresh injuries. […] There’s no specific test to diagnose self-injury. Diagnosis is based on a physical and psychological evaluation. You may be referred to a mental health professional with experience in treating self-injury for evaluation. This professional talks to you about your life, thoughts, feelings and behaviors. […] A mental health professional also may evaluate you for other mental health conditions that could be linked to self-injury, such as depression or personality disorders.

• #24 Nonsuicidal Self-Injury (NSSI) – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/suicidal-behavior-and-self-injury/nonsuicidal-self-injury-nssi

  Nonsuicidal self-injury is a self-inflicted act that causes pain or superficial damage but is not intended to cause death. […] Diagnosis of nonsuicidal self-injury must exclude suicidal behavior. […] Assessment of nonsuicidal self-injury, as for suicidal behavior, is essential before treatment begins. […] Facilitating discussion of the self-injury with the patient is essential to adequate assessment and helps physicians plan treatment. […] Assessment of nonsuicidal self-injury should include the following: determining what type of self-injury and how many types of self-injury the patient has inflicted, determining how often nonsuicidal self-injury occurs and how long it has been occurring, determining the function of nonsuicidal self-injury for the patient, checking for coexisting psychiatric disorders, estimating the risk of a suicide attempt, determining how willing the patient is to participate in treatment.

• #25 Nonsuicidal Self-Injury (NSSI) – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/suicidal-behavior-and-self-injury/nonsuicidal-self-injury-nssi

  Nonsuicidal self-injury is a self-inflicted act that causes pain or superficial damage but is not intended to cause death. […] Diagnosis of nonsuicidal self-injury must exclude suicidal behavior. […] Assessment of nonsuicidal self-injury, as for suicidal behavior, is essential before treatment begins. […] Facilitating discussion of the self-injury with the patient is essential to adequate assessment and helps physicians plan treatment. […] Assessment of nonsuicidal self-injury should include the following: determining what type of self-injury and how many types of self-injury the patient has inflicted, determining how often nonsuicidal self-injury occurs and how long it has been occurring, determining the function of nonsuicidal self-injury for the patient, checking for coexisting psychiatric disorders, estimating the risk of a suicide attempt, determining how willing the patient is to participate in treatment.

• #26 Nonsuicidal Self-Injury (NSSI) – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/suicidal-behavior-and-self-injury/nonsuicidal-self-injury-nssi

  Nonsuicidal self-injury is a self-inflicted act that causes pain or superficial damage but is not intended to cause death. […] Diagnosis of nonsuicidal self-injury must exclude suicidal behavior. […] Assessment of nonsuicidal self-injury, as for suicidal behavior, is essential before treatment begins. […] Facilitating discussion of the self-injury with the patient is essential to adequate assessment and helps physicians plan treatment. […] Assessment of nonsuicidal self-injury should include the following: determining what type of self-injury and how many types of self-injury the patient has inflicted, determining how often nonsuicidal self-injury occurs and how long it has been occurring, determining the function of nonsuicidal self-injury for the patient, checking for coexisting psychiatric disorders, estimating the risk of a suicide attempt, determining how willing the patient is to participate in treatment.

• #27 Nonsuicidal Self-Injury (NSSI) – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/suicidal-behavior-and-self-injury/nonsuicidal-self-injury-nssi

  Nonsuicidal self-injury is a self-inflicted act that causes pain or superficial damage but is not intended to cause death. […] Diagnosis of nonsuicidal self-injury must exclude suicidal behavior. […] Assessment of nonsuicidal self-injury, as for suicidal behavior, is essential before treatment begins. […] Facilitating discussion of the self-injury with the patient is essential to adequate assessment and helps physicians plan treatment. […] Assessment of nonsuicidal self-injury should include the following: determining what type of self-injury and how many types of self-injury the patient has inflicted, determining how often nonsuicidal self-injury occurs and how long it has been occurring, determining the function of nonsuicidal self-injury for the patient, checking for coexisting psychiatric disorders, estimating the risk of a suicide attempt, determining how willing the patient is to participate in treatment.

• #28 Nonsuicidal Self-Injury (NSSI) – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/suicidal-behavior-and-self-injury/nonsuicidal-self-injury-nssi

  Nonsuicidal self-injury is a self-inflicted act that causes pain or superficial damage but is not intended to cause death. […] Diagnosis of nonsuicidal self-injury must exclude suicidal behavior. […] Assessment of nonsuicidal self-injury, as for suicidal behavior, is essential before treatment begins. […] Facilitating discussion of the self-injury with the patient is essential to adequate assessment and helps physicians plan treatment. […] Assessment of nonsuicidal self-injury should include the following: determining what type of self-injury and how many types of self-injury the patient has inflicted, determining how often nonsuicidal self-injury occurs and how long it has been occurring, determining the function of nonsuicidal self-injury for the patient, checking for coexisting psychiatric disorders, estimating the risk of a suicide attempt, determining how willing the patient is to participate in treatment.

• #29 Nonsuicidal Self-Injury (NSSI) – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/suicidal-behavior-and-self-injury/nonsuicidal-self-injury-nssi

  Nonsuicidal self-injury is a self-inflicted act that causes pain or superficial damage but is not intended to cause death. […] Diagnosis of nonsuicidal self-injury must exclude suicidal behavior. […] Assessment of nonsuicidal self-injury, as for suicidal behavior, is essential before treatment begins. […] Facilitating discussion of the self-injury with the patient is essential to adequate assessment and helps physicians plan treatment. […] Assessment of nonsuicidal self-injury should include the following: determining what type of self-injury and how many types of self-injury the patient has inflicted, determining how often nonsuicidal self-injury occurs and how long it has been occurring, determining the function of nonsuicidal self-injury for the patient, checking for coexisting psychiatric disorders, estimating the risk of a suicide attempt, determining how willing the patient is to participate in treatment.

• #30 Help! I think my teenager is cutting – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/help-i-think-my-teenager-is-cutting

  Self-injury or cutting often starts in the preteen or early teen years. […] No simple reason or diagnosis can explain why someone engages in self-harming behavior, but emotional pain almost always is a constant. […] Self-harm behavior can lead to significant problems including infection, permanent scarring and disfigurement. In extreme cases, the injury could be fatal. […] Self-injury typically is not meant as a suicide attempt, although it still is serious and is associated with elevated suicide risk. […] Many patients report that before engaging in such behavior, they experience either an uncomfortable sense of numbness inside, or they feel overwhelming or confusing emotions and don’t know what to do with them. […] There is no one-size-fits-all kind of treatment for someone who is exhibiting self-harm behaviors. A treatment plan will include therapy to get to the root of the emotional pain and, at times, medications to help with underlying mental health issues, such as depression or anxiety. […] Management of cutting or other such behaviors will require time, hard work and a desire to learn healthier coping skills. A specific kind of therapy called dialectical behavioral therapy, or DBT, may be helpful.

• #31 Diagnosing self-harm cases | Hospital Clínic Barcelona

  https://www.clinicbarcelona.org/en/assistance/be-healthy/self-harm/diagnosis

  The doctor will probably ask for information about: Physical health. Social relations. The self-harm methods used. How often they self-harm. Situations or feelings that happen before self-harming. Strategies they have tried for avoiding self-harming. Plans to self-harm again. Thoughts of suicide. […] This information will help the doctor decide what type of help they need.

• #32 How Are Self-Injury and Suicide Related? – Child Mind Institute

  https://childmind.org/article/how-are-self-injury-and-suicide-related/

  The intent is different, though one can lead to the other […] Self-injury and suicidal behaviors — imagining, planning or attempting suicide — are related, but the relationship between the two is confusing. Because they can look similar, it can be very difficult to tell the difference between them. But there are important differences in the intention as well as the danger: Self-injury is virtually always used to feel better rather than to end one’s life. Indeed, some people who self-injure are clear that it helps them to avoid suicide. In fact, the technical term for self-injury is non-suicidal self-injury, or NSSI. […] Self-injury and suicide differ in multiple ways, including: The intent: The intent of self-injury is almost always to feel better, whereas for suicide it is to end feeling (and, hence, life) altogether.

• #33 Self-Injurious Behavior in an Adolescent | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0301/p609.html

  Although most cases of nonsuicidal self-injury is maladaptive coping (i.e., attempts to influence the behaviors of others or deal with internal emotions), the risk of suicide is real. In a review of adolescents presenting for emergency care following a suicide attempt, almost one-half had engaged in nonsuicidal self-injury in the previous 24 hours. In another study, patients engaging in nonsuicidal self-injury were six times more likely to attempt suicide than those who did not report nonsuicidal self-injury. There is no validated model to determine suicide risk in those with nonsuicidal self-injury, although there is some evidence to suggest the following may relate to suicide risk: (1) severity of depressive symptoms; (2) level of self-esteem; (3) parental support; (4) suicidal ideation; and (5) reason to live.

• #34 What Is Cutting and What Are the Warning Signs? | Self-Harm

  https://www.hhills.com/rehab-blog/what-is-cutting-and-what-are-the-warning-signs/

  Most cutting is done on body parts that can easily be covered by clothing, commonly the arms, thighs, and torso, with objects that are small, common, and easy to hide, such as thumbtacks, paperclips, safety pins, nail files, or razor blades. […] Cutting and self-injury are maladaptive coping skills, not suicide attempts. […] According to reports from Mental Health America, individuals who self-injure are ultimately nine times more likely to attempt suicide, highlighting the need for professional self-harm treatment. […] The leading causes of cutting and self-injury are poor coping skills and an inability to manage emotions in healthy ways. […] Whatever the reason for cutting and other self-injury, it is essential for individuals to know that help is available and to understand the potential consequences of not getting help.

• #35 What Is Self-Injury Disorder?

  https://www.webmd.com/anxiety-panic/self-injuring-hurting

  How Is Self-Injury Diagnosed? […] If an individual shows signs of self-injury, a mental health professional with self-injury expertise should be consulted. That person will be able to make an evaluation and recommend a course of treatment. Self-injury can be a symptom of psychiatric illness including: […] Personality disorders (particularly borderline personality disorder) […] Substance use disorders […] Bipolar disorder […] Major depression […] Anxiety disorders (particularly obsessive-compulsive disorder) […] Schizophrenia […] The prognosis for self-injurious behavior varies depending upon a person’s emotional or psychological state and the nature of any underlying psychiatric condition. It is important to determine the factors that lead to an individual’s self-injuring behaviors, and to identify and treat any pre-existing personality disorders.

• #36 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspective | NDT

  https://www.dovepress.com/nonsuicidal-self-injury-diagnostic-challenges-and-current-perspectives-peer-reviewed-fulltext-article-NDT

  The construct of NSSI has gained widespread acceptance in the USA, Europe, Australia, and many other parts of the world. […] By definition, NSSI must occur in the absence of suicidal intent. Yet NSSI can hardly be considered entirely nonsuicidal. […] NSSI has been included as a symptom of borderline personality disorder since personality disorders first officially entered the DSM in 1980. […] Reflecting this, NSSI disorder (NSSI-D) entered DSM-5 in 2013 as a Condition for Further Study. […] The diagnostic criteria for NSSI-D are summarized in Table 1. Criterion A concerns the frequency and duration of NSSI. […] A key issue, however, is whether the threshold of five NSSI days in the past year is too low to meaningfully differentiate between clinical and subclinical groups of people who engage in NSSI.

• #37 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  However, self-injury is not a sustainable or healthy way to manage emotions. […] Research has also found that people who engage in NSSI are at a much higher risk for suicide compared with the general population. […] The potential for severe symptoms in common self-harm conditions makes individuals more vulnerable to engaging in self-injury or even suicidal behaviors. […] Approximately half of the people with bipolar disorder engage in NSSI at least once in their life. […] Because symptoms in this condition can be very severe, the lifetime risk for suicidal behavior is believed to be about 20 to 30 times greater for those who have it. […] Characterized by impulsivity and instability in many areas of life, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5TR) also includes repeated self-harming behavior as well as suicidal thoughts, threats, and attempts as one of the criteria for a diagnosis of this condition.

• #38 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Repeated incidents of NSSI are common in borderline personality disorder and may be used to help manage the intense emotions they experience, offset feelings of unhappiness, or cope with distress. […] The previously referenced research from the Journal of Nervous and Mental Disease also found that 37% of people with unipolar depression (as opposed to bipolar depression) had engaged in NSSI at least once. […] Whats even more concerning, however, is that some of the symptoms inherent in this disorderespecially hopelessness and an inability to experience joy or pleasure in lifeare known to increase the chances of making a suicide attempt. […] A study published in the International Journal of Environmental Research and Public Health found that individuals with four or more adverse childhood experiences (ACEs) were more likely to repeatedly engage in NSSI and had a 12 times greater risk of committing suicide.

• #39 What Is Self-Injury Disorder?

  https://www.webmd.com/anxiety-panic/self-injuring-hurting

  How Is Self-Injury Diagnosed? […] If an individual shows signs of self-injury, a mental health professional with self-injury expertise should be consulted. That person will be able to make an evaluation and recommend a course of treatment. Self-injury can be a symptom of psychiatric illness including: […] Personality disorders (particularly borderline personality disorder) […] Substance use disorders […] Bipolar disorder […] Major depression […] Anxiety disorders (particularly obsessive-compulsive disorder) […] Schizophrenia […] The prognosis for self-injurious behavior varies depending upon a person’s emotional or psychological state and the nature of any underlying psychiatric condition. It is important to determine the factors that lead to an individual’s self-injuring behaviors, and to identify and treat any pre-existing personality disorders.

• #40 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Individuals with PTSD often suffer from flashbacks, nightmares, and severe anxiety, which can lead them to engage in self-injury behaviors. […] However, self-injury can worsen PTSD symptoms and increase the risk of suicidal behaviors. […] A study that analyzed the relationship between NSSI and eating disorders found up to 42% of people with anorexia and as much as 55% of those with bulimia engaged in self-harming behaviors. […] Self-harm is not unusual for people who have this severe mental illness. […] Suicidal ideation is also very common in this condition and 20% of people who are schizophrenic will attempt suicide at least once. […] Therefore, it is not surprising that self-harming behaviors are also found in some people who struggle with alcohol or substance abuse, which by their inherent nature, exacerbate underlying psychiatric symptoms.

• #41 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Individuals with PTSD often suffer from flashbacks, nightmares, and severe anxiety, which can lead them to engage in self-injury behaviors. […] However, self-injury can worsen PTSD symptoms and increase the risk of suicidal behaviors. […] A study that analyzed the relationship between NSSI and eating disorders found up to 42% of people with anorexia and as much as 55% of those with bulimia engaged in self-harming behaviors. […] Self-harm is not unusual for people who have this severe mental illness. […] Suicidal ideation is also very common in this condition and 20% of people who are schizophrenic will attempt suicide at least once. […] Therefore, it is not surprising that self-harming behaviors are also found in some people who struggle with alcohol or substance abuse, which by their inherent nature, exacerbate underlying psychiatric symptoms.

• #42 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Individuals with PTSD often suffer from flashbacks, nightmares, and severe anxiety, which can lead them to engage in self-injury behaviors. […] However, self-injury can worsen PTSD symptoms and increase the risk of suicidal behaviors. […] A study that analyzed the relationship between NSSI and eating disorders found up to 42% of people with anorexia and as much as 55% of those with bulimia engaged in self-harming behaviors. […] Self-harm is not unusual for people who have this severe mental illness. […] Suicidal ideation is also very common in this condition and 20% of people who are schizophrenic will attempt suicide at least once. […] Therefore, it is not surprising that self-harming behaviors are also found in some people who struggle with alcohol or substance abuse, which by their inherent nature, exacerbate underlying psychiatric symptoms.

• #43 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Individuals with PTSD often suffer from flashbacks, nightmares, and severe anxiety, which can lead them to engage in self-injury behaviors. […] However, self-injury can worsen PTSD symptoms and increase the risk of suicidal behaviors. […] A study that analyzed the relationship between NSSI and eating disorders found up to 42% of people with anorexia and as much as 55% of those with bulimia engaged in self-harming behaviors. […] Self-harm is not unusual for people who have this severe mental illness. […] Suicidal ideation is also very common in this condition and 20% of people who are schizophrenic will attempt suicide at least once. […] Therefore, it is not surprising that self-harming behaviors are also found in some people who struggle with alcohol or substance abuse, which by their inherent nature, exacerbate underlying psychiatric symptoms.

• #44

  https://www.autism.org.uk/advice-and-guidance/topics/mental-health/self-harm

  Self-harm is when somebody intentionally hurts themselves. It is often a way to express or deal with distress. Self-harm can affect anyone at any age but is more common in young people. A lack of research means we do not know how many autistic people self-harm. Self-harm can significantly affect your physical and mental health, so it is important to get help as early as possible. […] The NHS describes self-harm as follows: 'Self-harm is when somebody intentionally damages or injures their body. Self-harm is most often described as a way to express or cope with emotional distress.’ […] Self-harm can affect anyone. Some studies suggest that: autistic people are more likely to self-harm than non-autistic people; autistic women are more likely to self-harm than autistic men. […] Self-harm can be a coping mechanism, without suicidal intent. However, evidence shows that those who have self-harmed in the past have a higher risk of suicidal thoughts and attempts.

• #45 Self-harm and autism | Autistica

  https://www.autistica.org.uk/what-is-autism/anxiety-and-autism-hub/self-harm-and-autism

  Self-harm is when a person deliberately injures themselves. The methods used to cause the injury can take many forms. It has been reported that up to half of autistic people show self-harming behaviour. […] Many autistic people find it difficult to recognise, manage and express their emotions. This is known as alexithymia. It can mean that autistic people who experience alexithymia are more likely to feel frustrated, anxious and depressed, and less able to effectively cope with these emotions. Higher levels of alexithymia are linked to higher levels of self-harm in autistic people. […] Some people worry that people who self-harm are suicidal. Research with autistic adults has shown that some people who self-harm have no intention of killing themselves. Self-harm does not necessarily correspond with desire to die, but research suggests it may be linked to a greater risk of suicide in future. For this reason, its important to take self-harm seriously.

• #46 Self Injury in Autism: Causes and Interventions – Autism Research Institute

  https://autism.org/causes-and-interventions-for-self-injury-in-autism/

  Strictly speaking, self-injury is not a symptom of autism. However, certain symptoms, situations, and comorbidities related to ASD can lead some people with autism to engage in self-injurious behavior. Treating underlying disorders and helping the individual to learn additional communication and coping skills can enable them to avoid self-injury and minimize the long-term effects of this behavior. […] Your clinician may use a functional behavioral assessment (FBA) to help identify the function of self-injurious behavior for the individual. This process includes: defining the behavior: using specific, observable language to describe what the self-injury looks like; gathering and analyzing information: exploring when, where, and how the behavior is occurring, the consequences of the behavior, and the people and situations that seem to be related; identifying reasons or causes: making an informed hypothesis about what might be causing the behavior or what the child is trying to communicate; making a plan to address the situation: specifying actions and interventions to help improve communication or reduce trigger events.

• #47 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6959491/

  Nonsuicidal self-injury (NSSI) involves deliberate and intentional injury to body tissue that occurs in the absence of suicidal intent. Typical examples here might include self-cutting, burning, or self-hitting. […] Much has changed over time, culminating in the entry of NSSI Disorder into DSM-5 as a condition in need of further study. In this review we describe the evolution of the NSSI construct and consider current issues in its diagnosis and assessment. […] For a behavior to be classified as NSSI (according to both Favazza’s definition and the DSM-5 diagnostic criteria) it must be intentional and deliberate. […] As we have noted and as the name itself suggests, NSSI must also be nonsuicidal. […] NSSI must be distinguished from the stereotypic self-injury that occurs in many developmental disorders.

• #48 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6959491/

  Criterion B of NSSI-D in the DSM-5 requires that individuals engage in NSSI for one or more of the following reasons: (1) to obtain relief from a negative feeling or cognitive state, (2) to resolve an interpersonal difficulty, or (3) to induce a positive feeling state. […] The C Criterion of DSM-5 highlights the thoughts or mood states that are required to accompany self-injurious behavior. […] The D criterion is useful, however, because it creates boundary conditions and formally excludes socially sanctioned behaviors such as body piercing. […] The F Criterion clarifies the contexts where this is the case. […] With respect to NSSI, however, this is potentially problematic. […] In recent years, several interview-based and self-report measures have been developed to assess NSSI. […] Most NSSI assessments predate the entry of NSSI-D into the DSM-5 as a condition for further study. […] The addition of NSSI-D into the DSM represents a major step forward for research in this area. […] Despite these challenges, we agree with Selby et al and also with Brausch that recognizing NSSI-D brings with it many advantages.

• #49 Nonsuicidal Self-Injury DSM-5

  https://www.theravive.com/therapedia/nonsuicidal-self–injury-dsm–5

  It is for this reason that the American Psychiatric Associations DSM-5 Child and Adolescent Disorders Workgroup pushed for the classification of NSSI with its own diagnostic criteria (In-Albon, Ruf, Schmid, 2013). […] According to DSM-5, NSSI diagnostic criteria are as follows (American Psychiatric Association, 2013): Over the past year, the person has for at least 5 days engaged in self-injury, with the anticipation that the injury will result in some bodily harm. No suicidal intent. […] The act is not socially acceptable. […] The act or its consequence can cause significant distress to the individuals daily life. […] The act is not taking place during psychotic episodes, delirium, substance intoxication, or substance withdrawal. It also cannot be explained by another medical condition.

• #50 Cutting and Self-Harm | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816934/1.0/Cutting_and_Self_Harm

  NSSI broadly defined as deliberate self-inflicted damage to body tissues and/or infliction of pain without the intent to die. […] NSSI and suicidal behavior are separate but often co-occurring behaviors: 5585% of people with history of NSSI also report history of suicidal behavior. […] Self-harm does not include body modifications, piercings, or tattoos; also does not include skin-picking, nail-biting, repetitive stereotypies, psychosis, or delirium. […] Classified in Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), under Conditions for Further Study. […] History of self-harm and/or suicidality. […] Diagnosis of major depressive disorder (MDD), specific phobias, obsessive-compulsive disorder (OCD), externalizing disorders, substance use, and borderline personality disorder (BPD).

• #51 How Are Self-Injury and Suicide Related? – Child Mind Institute

  https://childmind.org/article/how-are-self-injury-and-suicide-related/

  The intent is different, though one can lead to the other […] Self-injury and suicidal behaviors — imagining, planning or attempting suicide — are related, but the relationship between the two is confusing. Because they can look similar, it can be very difficult to tell the difference between them. But there are important differences in the intention as well as the danger: Self-injury is virtually always used to feel better rather than to end one’s life. Indeed, some people who self-injure are clear that it helps them to avoid suicide. In fact, the technical term for self-injury is non-suicidal self-injury, or NSSI. […] Self-injury and suicide differ in multiple ways, including: The intent: The intent of self-injury is almost always to feel better, whereas for suicide it is to end feeling (and, hence, life) altogether.

• #52 Cutting & Self-Harm: Signs, Diagnosis & Treatment Options – Mission Connection Healthcare

  https://missionconnectionhealthcare.com/what-we-treat/self-harm/

  Cutting and self-harm can be difficult topics to talk about. […] How cutting and self-harm are diagnosed. […] When diagnosing self-harm, a mental health provider will typically schedule an initial assessment. This usually involves a conversational interview to discuss how long the self-injury has been occurring and the types of methods used. […] A professional evaluation can also determine if the self-injury diagnosis coincides with mental health conditions such as: […] While it’s normal to feel nervous about seeking help, a mental health professional can best assess the level of support needed for safety and recovery. Compassionate and empathetic care is an essential part of reducing the stigma associated with a self-injury diagnosis. […] Self-harm does not need to be a lifelong condition. It’s possible to learn how to stop self-harm and discover healthier ways of coping.

• #53 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspective | NDT

  https://www.dovepress.com/nonsuicidal-self-injury-diagnostic-challenges-and-current-perspectives-peer-reviewed-fulltext-article-NDT

  The NSSIDS uses Likert-scale items to assess each NSSI-D criterion. […] The addition of NSSI-D into the DSM represents a major step forward for research in this area. […] Whether NSSI should remain categorical (diagnosis versus no diagnosis) or be assessed dimensionally (on a scale of severity) remains an open question. […] The validity of the current DSM-5 criteria remains to be fully established and many changes are to be expected for the future.

• #54 Self-Injurious Behavior in an Adolescent | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0301/p609.html

  Although most cases of nonsuicidal self-injury is maladaptive coping (i.e., attempts to influence the behaviors of others or deal with internal emotions), the risk of suicide is real. In a review of adolescents presenting for emergency care following a suicide attempt, almost one-half had engaged in nonsuicidal self-injury in the previous 24 hours. In another study, patients engaging in nonsuicidal self-injury were six times more likely to attempt suicide than those who did not report nonsuicidal self-injury. There is no validated model to determine suicide risk in those with nonsuicidal self-injury, although there is some evidence to suggest the following may relate to suicide risk: (1) severity of depressive symptoms; (2) level of self-esteem; (3) parental support; (4) suicidal ideation; and (5) reason to live.

• #55 Self-injury/cutting | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/self-injurycutting

  Although some people may ask for help, sometimes family or friends discover the self-injury. Or a health care provider doing a routine medical exam may notice signs, such as scars or fresh injuries. […] There’s no specific test to diagnose self-injury. Diagnosis is based on a physical and psychological evaluation. You may be referred to a mental health professional with experience in treating self-injury for evaluation. This professional talks to you about your life, thoughts, feelings and behaviors. […] A mental health professional also may evaluate you for other mental health conditions that could be linked to self-injury, such as depression or personality disorders.

• #56 Self-Harm: What It Is, Causes, Types & Treatment

  https://my.clevelandclinic.org/health/diseases/12201-self-harm

  Self-injury is when you injure yourself on purpose. Also known as nonsuicidal self-injury disorder, people who self-harm do things to hurt themselves but don’t want to cause death. […] Nonsuicidal self-injury disorder can be difficult to diagnose. People who self-harm tend to hide their injuries and avoid talking about them. […] Healthcare providers don’t use a specific test to diagnose self-harm. Instead, they inspect your injuries, looking for patterns and scars from previous self-harm. […] If you see a healthcare provider about self-harm, they’ll first treat your injuries if needed. Longer term, they may recommend therapy and/or medications to help manage underlying mental health conditions and life stressors. […] Getting treatment for self-harm is important because it has several potential short- and long-term risks.

• #57 Logo for Cambridge Core from Cambridge University Press. Click to return to homepage.

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/nonsuicidal-selfinjury-v-attempted-suicide-new-diagnosis-or-false-dichotomy/BF7295C2297829CF41C763E5F6D37201

  Non-suicidal self-injury (NSSI) is a term that is becoming popular especially in North America and it has been proposed as a new diagnosis in DSM-5. […] But is the time really right to create a new diagnosis of non-suicidal self-injury (NSSI), or are we simply in danger of creating a false dichotomy? […] A diagnosis of NSSI would mean that adolescents might avoid a potentially inappropriate personality disorder label, while still having a formal diagnosis for which they could receive treatment. […] Unfortunately, the evidence base is weak. […] Despite this, the term NSSI has gained popularity, especially in the USA, and it has been proposed for inclusion in DSM-5, with the Childhood and Adolescent Disorders Work Group developing the diagnostic criteria. […] First and most importantly, the prefix non-suicidal is misleading because of the strong association between NSSI and suicidal behaviour – in one study of a community sample of adults, over a third of respondents reported that they had engaged in NSSI while actually experiencing suicidal thoughts.

• #58 Logo for Cambridge Core from Cambridge University Press. Click to return to homepage.

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/nonsuicidal-selfinjury-v-attempted-suicide-new-diagnosis-or-false-dichotomy/BF7295C2297829CF41C763E5F6D37201

  Longitudinal research has identified NSSI as one of the most important risk factors for suicide attempts. […] Self-cutting is the most common method of NSSI and a behaviour that is often regarded as being of limited seriousness by clinical services. […] However, there is evidence that self-cutting that results in hospital treatment is actually associated with greater risk of eventual suicide than self-poisoning in both adults and adolescents. […] There is an argument that one of the main distinctions between suicidal and non-suicidal self-injury is the motivation underlying the act – a wish to die as opposed to seeking relief from distressing symptoms. […] However, self-injury as a whole is often characterised by multiple motivations existing simultaneously. […] This guidance recommends that the presence/absence of suicidal intent associated with both current and past episodes of self-harm should be assessed.

• #59 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspective | NDT

  https://www.dovepress.com/nonsuicidal-self-injury-diagnostic-challenges-and-current-perspectives-peer-reviewed-fulltext-article-NDT

  The construct of NSSI has gained widespread acceptance in the USA, Europe, Australia, and many other parts of the world. […] By definition, NSSI must occur in the absence of suicidal intent. Yet NSSI can hardly be considered entirely nonsuicidal. […] NSSI has been included as a symptom of borderline personality disorder since personality disorders first officially entered the DSM in 1980. […] Reflecting this, NSSI disorder (NSSI-D) entered DSM-5 in 2013 as a Condition for Further Study. […] The diagnostic criteria for NSSI-D are summarized in Table 1. Criterion A concerns the frequency and duration of NSSI. […] A key issue, however, is whether the threshold of five NSSI days in the past year is too low to meaningfully differentiate between clinical and subclinical groups of people who engage in NSSI.

• #60 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspective | NDT

  https://www.dovepress.com/nonsuicidal-self-injury-diagnostic-challenges-and-current-perspectives-peer-reviewed-fulltext-article-NDT

  The construct of NSSI has gained widespread acceptance in the USA, Europe, Australia, and many other parts of the world. […] By definition, NSSI must occur in the absence of suicidal intent. Yet NSSI can hardly be considered entirely nonsuicidal. […] NSSI has been included as a symptom of borderline personality disorder since personality disorders first officially entered the DSM in 1980. […] Reflecting this, NSSI disorder (NSSI-D) entered DSM-5 in 2013 as a Condition for Further Study. […] The diagnostic criteria for NSSI-D are summarized in Table 1. Criterion A concerns the frequency and duration of NSSI. […] A key issue, however, is whether the threshold of five NSSI days in the past year is too low to meaningfully differentiate between clinical and subclinical groups of people who engage in NSSI.

• #61 Self-harm and self-injury | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/self-harm

  Self-harming behaviour is treatable. […] Self-injury is a type of self-harm, and refers to deliberately causing pain or damage to your own body without suicidal intent. […] Self-harming is a serious behaviour its a sign someone is feeling significant distress and theyre not doing it to seek attention. […] Although self-harming behaviour can be treated, many people dont seek support because they: […] No one has to cope alone; self-harming behaviour is treatable. […] For anyone who self-harms, just realising it is a not a long-term solution to problems is a step in the right direction. […] Self-harm may bring relief in the short-term, it doesnt help the person address the reasons they are doing it in the first place. […] Unfortunately, self-harm can be dangerous it can lead to serious injury and even accidental death. […] Many people who attempt suicide have a history of self-harm.

• #62 How Are Self-Injury and Suicide Related? – Child Mind Institute

  https://childmind.org/article/how-are-self-injury-and-suicide-related/

  Because of these common risk factors, it is important for you to know that youth who self-injure are also at increased risk for suicidality. Our work shows that about 65 percent of youth who self-injure will also be suicidal at some point (though many will not go beyond having suicidal thoughts). […] Although self-injury does not cause suicide, the other important thing to know about the relationship between self-injury and suicide is that the very act of engaging in self-injury reduces inhibition to suicidal behavior if someone becomes suicidal.

• #63 Self-Harm: What It Is, Causes, Types & Treatment

  https://my.clevelandclinic.org/health/diseases/12201-self-harm

  Self-harm behaviors can lead to infections, nerve damage and permanent and/or severe scarring. […] Self-harm can also lead to long-term issues, including worsening mental health. […] Nonsuicidal self-injury disorder doesn’t involve suicidal intent. But the risk of attempting or dying by suicide is much higher for people who self-harm.

• #64 Self-Harm: Causes, Warning Signs, & How to Find Help

  https://lifeskillssouthflorida.com/mental-health-blog/self-harm-causes-signs-help/

  Self-harm can often be mistaken for suicidal ideation by those unfamiliar with the behavior. While self-injury may sometimes precede suicidal thoughts or actions, it does not necessarily indicate that an individual is contemplating suicide. […] However, research indicates that non-suicidal self-injury can be a significant predictor of future suicidal ideation or attempts. With 12.1% of adolescents reporting suicidal thoughts and 4.1% having at least one attempt by age 18, it’s crucial to take self-harm seriously, regardless of intent. The earlier someone experiencing self-injury receives the care and support they need, the less likely it is that their behavior will escalate to suicidal thoughts or attempts. […] Mental health treatment addresses all aspects of self-harm, including the underlying mental health disorders or trauma that may contribute to these behaviors.

• #65 Understanding Compulsive Self-Mutilation | OCD Treatment Center

  https://www.promises.com/addiction-blog/compulsive-self-mutilation/

  Since people who struggle with compulsive self-mutilation often suffer from other psychiatric disorders, such as PTSD or major depression, a successful treatment plan will also integrate therapies to address those conditions as well. […] One of the challenges with compulsive self-mutilation is that the damage may also generate physical injury that requires medical treatment.

• #66 Self-harm and self-injury | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/self-harm

  Self-harming behaviour is treatable. […] Self-injury is a type of self-harm, and refers to deliberately causing pain or damage to your own body without suicidal intent. […] Self-harming is a serious behaviour its a sign someone is feeling significant distress and theyre not doing it to seek attention. […] Although self-harming behaviour can be treated, many people dont seek support because they: […] No one has to cope alone; self-harming behaviour is treatable. […] For anyone who self-harms, just realising it is a not a long-term solution to problems is a step in the right direction. […] Self-harm may bring relief in the short-term, it doesnt help the person address the reasons they are doing it in the first place. […] Unfortunately, self-harm can be dangerous it can lead to serious injury and even accidental death. […] Many people who attempt suicide have a history of self-harm.

• #67 Cutting: Self-Harm, on Arm, Yourself, Self-Injury, in Adults, and More

  https://www.healthline.com/health/cutting

  Cutting is a form self-injury not typically associated with suicide. But it can lead to severe, even fatal, injury. […] Self-injury sometimes goes along with other mental health issues such as depression, anxiety disorders, eating disorders, and post-traumatic stress disorder (PTSD). […] Cutting can exacerbate negative emotions. It can also lead to worsening mental and physical problems such as: increased feelings of guilt and shame, becoming addicted to cutting, infection of the wounds, permanent scarring, severe injury requiring medical treatment, accidental fatal injury, increased risk of suicide. […] The first step is to speak to a doctor. A mental health evaluation will determine if there are contributing conditions such as depression, anxiety, or personality disorders. […] Theres no drug treatment specifically for self-harming behaviors. But if there is a coexisting mental health disorder, medication may be appropriate. The treatment plan will take all this into consideration.

• #68 Cutting: Self-Harm, on Arm, Yourself, Self-Injury, in Adults, and More

  https://www.healthline.com/health/cutting

  The main treatment is talk therapy (psychotherapy). The goals are as follows: Identify triggers, Learn methods of managing emotions and tolerating stress, Learn how to replace unhealthy behaviors with positive ones, Work on relationship skills, Develop problem-solving skills, Boost self-image, Deal with traumatic events in your past. […] Along with individual therapy, the doctor may recommend group or family therapy. For those who have severely injured themselves or have had suicidal thoughts, short-term hospitalization may be helpful.

• #69 Nonsuicidal Self-Injury: Diagnostic Challenges And Current Perspective | NDT

  https://www.dovepress.com/nonsuicidal-self-injury-diagnostic-challenges-and-current-perspectives-peer-reviewed-fulltext-article-NDT

  The construct of NSSI has gained widespread acceptance in the USA, Europe, Australia, and many other parts of the world. […] By definition, NSSI must occur in the absence of suicidal intent. Yet NSSI can hardly be considered entirely nonsuicidal. […] NSSI has been included as a symptom of borderline personality disorder since personality disorders first officially entered the DSM in 1980. […] Reflecting this, NSSI disorder (NSSI-D) entered DSM-5 in 2013 as a Condition for Further Study. […] The diagnostic criteria for NSSI-D are summarized in Table 1. Criterion A concerns the frequency and duration of NSSI. […] A key issue, however, is whether the threshold of five NSSI days in the past year is too low to meaningfully differentiate between clinical and subclinical groups of people who engage in NSSI.

• #70 DSM-5 non-suicidal self-injury criteria in a clinical sample of self-harming Mexican adolescents | Revista Colombiana de Psiquiatría (English Edition)

  https://www.elsevier.es/es-revista-revista-colombiana-psiquiatria-english-edition–479-articulo-dsm-5-non-suicidal-self-injury-criteria-in-S2530312020300035

  The DSM-5 diagnostic criteria for non-suicidal self-injury (NSSI) need to be validated in non-European populations. […] NSSI was diagnosed in 351 patients (60%) with evidence of self-harm. […] More than half of the adolescents in the clinical sample with self-injury met DSM-5 criteria for NSSI. […] The results of this study show that 60% of self-harming adolescent patients fulfil the NSSI criteria of the DSM-5. […] It is important to carry out more studies on this diagnosis in Latin American adolescents. […] This study provides information on the validity of this category in populations of Hispanic origin, as it reveals that more than half of the self-harming subjects could fulfil the diagnostic criteria established in the DSM-5 and shows the clinical characteristics that could be associated with this diagnosis in Mexican adolescents.

• #71 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  However, self-injury is not a sustainable or healthy way to manage emotions. […] Research has also found that people who engage in NSSI are at a much higher risk for suicide compared with the general population. […] The potential for severe symptoms in common self-harm conditions makes individuals more vulnerable to engaging in self-injury or even suicidal behaviors. […] Approximately half of the people with bipolar disorder engage in NSSI at least once in their life. […] Because symptoms in this condition can be very severe, the lifetime risk for suicidal behavior is believed to be about 20 to 30 times greater for those who have it. […] Characterized by impulsivity and instability in many areas of life, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5TR) also includes repeated self-harming behavior as well as suicidal thoughts, threats, and attempts as one of the criteria for a diagnosis of this condition.

• #72 Top Psychiatric Disorders Most at Risk for Self-Injury 

  https://mypsychiatrist.com/blog/psychiatric-disorders-at-risk-for-self-injury/

  Self-harm can become lethal. It also worsens a persons mental condition by feeding into their insecurities, worries, pain, and fears. […] According to research, about 50% of people with bipolar disorder exhibit self-harm symptoms. […] Studies also show that bipolar patients are more likely to self-injure during the mixed state of the disorder, where both the manic and depressive symptoms manifest. […] The rate of suicidal tendencies is much higher during the mixed state than during the mania and depressive phase. […] Statistics show that females with bipolar are more likely to hurt themselves deliberately than men. […] Self-harm and suicidal tendencies and attempts are part of the diagnosis criteria for borderline personality disorder (BPD). Research shows that 50% to 80% of borderline personality disorder cases exhibit self-injury.

• #73 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Repeated incidents of NSSI are common in borderline personality disorder and may be used to help manage the intense emotions they experience, offset feelings of unhappiness, or cope with distress. […] The previously referenced research from the Journal of Nervous and Mental Disease also found that 37% of people with unipolar depression (as opposed to bipolar depression) had engaged in NSSI at least once. […] Whats even more concerning, however, is that some of the symptoms inherent in this disorderespecially hopelessness and an inability to experience joy or pleasure in lifeare known to increase the chances of making a suicide attempt. […] A study published in the International Journal of Environmental Research and Public Health found that individuals with four or more adverse childhood experiences (ACEs) were more likely to repeatedly engage in NSSI and had a 12 times greater risk of committing suicide.

• #74 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Repeated incidents of NSSI are common in borderline personality disorder and may be used to help manage the intense emotions they experience, offset feelings of unhappiness, or cope with distress. […] The previously referenced research from the Journal of Nervous and Mental Disease also found that 37% of people with unipolar depression (as opposed to bipolar depression) had engaged in NSSI at least once. […] Whats even more concerning, however, is that some of the symptoms inherent in this disorderespecially hopelessness and an inability to experience joy or pleasure in lifeare known to increase the chances of making a suicide attempt. […] A study published in the International Journal of Environmental Research and Public Health found that individuals with four or more adverse childhood experiences (ACEs) were more likely to repeatedly engage in NSSI and had a 12 times greater risk of committing suicide.

• #75 Top Psychiatric Disorders Most at Risk for Self-Injury 

  https://mypsychiatrist.com/blog/psychiatric-disorders-at-risk-for-self-injury/

  Self-harm can become lethal. It also worsens a persons mental condition by feeding into their insecurities, worries, pain, and fears. […] According to research, about 50% of people with bipolar disorder exhibit self-harm symptoms. […] Studies also show that bipolar patients are more likely to self-injure during the mixed state of the disorder, where both the manic and depressive symptoms manifest. […] The rate of suicidal tendencies is much higher during the mixed state than during the mania and depressive phase. […] Statistics show that females with bipolar are more likely to hurt themselves deliberately than men. […] Self-harm and suicidal tendencies and attempts are part of the diagnosis criteria for borderline personality disorder (BPD). Research shows that 50% to 80% of borderline personality disorder cases exhibit self-injury.

• #76 Top Psychiatric Disorders Most at Risk for Self-Injury 

  https://mypsychiatrist.com/blog/psychiatric-disorders-at-risk-for-self-injury/

  Self-harm can become lethal. It also worsens a persons mental condition by feeding into their insecurities, worries, pain, and fears. […] According to research, about 50% of people with bipolar disorder exhibit self-harm symptoms. […] Studies also show that bipolar patients are more likely to self-injure during the mixed state of the disorder, where both the manic and depressive symptoms manifest. […] The rate of suicidal tendencies is much higher during the mixed state than during the mania and depressive phase. […] Statistics show that females with bipolar are more likely to hurt themselves deliberately than men. […] Self-harm and suicidal tendencies and attempts are part of the diagnosis criteria for borderline personality disorder (BPD). Research shows that 50% to 80% of borderline personality disorder cases exhibit self-injury.

• #77 What Is Self-Injury Disorder?

  https://www.webmd.com/anxiety-panic/self-injuring-hurting

  How Is Self-Injury Diagnosed? […] If an individual shows signs of self-injury, a mental health professional with self-injury expertise should be consulted. That person will be able to make an evaluation and recommend a course of treatment. Self-injury can be a symptom of psychiatric illness including: […] Personality disorders (particularly borderline personality disorder) […] Substance use disorders […] Bipolar disorder […] Major depression […] Anxiety disorders (particularly obsessive-compulsive disorder) […] Schizophrenia […] The prognosis for self-injurious behavior varies depending upon a person’s emotional or psychological state and the nature of any underlying psychiatric condition. It is important to determine the factors that lead to an individual’s self-injuring behaviors, and to identify and treat any pre-existing personality disorders.

• #78 Understanding Compulsive Self-Mutilation | OCD Treatment Center

  https://www.promises.com/addiction-blog/compulsive-self-mutilation/

  If you or someone you know is struggling with compulsive self-mutilation, reach out for professional help. […] OCD and self-harm often go hand-in-hand, as individuals can feel compelled to engage in behavior that is ultimately harmful to them. […] It is important to understand that these behaviors are not intentional attempts to hurt oneself but instead are a way of managing distress and anxiety. […] It is also important to remember that self-harm due to OCD is treatable, and with the right support and treatment, individuals can learn to better manage their symptoms and lead healthy, meaningful lives. […] One of the most effective types of treatment for compulsive self-mutilation disorders is cognitive-behavioral therapy (CBT). […] By doing so, they can learn to replace self-harming behavior with healthy ways to cope with anxiety, emotional pain, and other triggers.

• #79 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Individuals with PTSD often suffer from flashbacks, nightmares, and severe anxiety, which can lead them to engage in self-injury behaviors. […] However, self-injury can worsen PTSD symptoms and increase the risk of suicidal behaviors. […] A study that analyzed the relationship between NSSI and eating disorders found up to 42% of people with anorexia and as much as 55% of those with bulimia engaged in self-harming behaviors. […] Self-harm is not unusual for people who have this severe mental illness. […] Suicidal ideation is also very common in this condition and 20% of people who are schizophrenic will attempt suicide at least once. […] Therefore, it is not surprising that self-harming behaviors are also found in some people who struggle with alcohol or substance abuse, which by their inherent nature, exacerbate underlying psychiatric symptoms.

• #80 Self-Harm — Seattle Anxiety Specialists – Psychiatry, Psychology, and Psychotherapy

  https://seattleanxiety.com/selfharm

  Self-harm is a form of distress caused by an individual purposefully injuring their own body without the intention of committing suicide. […] The Diagnostic and Statistical Manual, fifth version (DSM-5) also added non-suicidal self-injury disorder (NSSID) as a medical diagnosis in 2015. […] While all forms of self-harm need professional treatment, there are also instances when self-harm leads to emergency medical care. […] An average of 18% of adolescents aged 12-18 and 4% of adults report that they have intentionally injured themselves. […] Research conducted by the Cleveland State University Counseling Center (2023) found there is an increasing prevalence of self-injury among adolescents and young adults. […] Regardless of their gender, according to a 2013 study by Muehlenkamp and colleagues, individuals that self-harm tend to have larger issues with body devaluation, with eating disorders occurring in 55% of those who self-injure. […] A health care provider may recommend a hospital for psychiatric care.

• #81 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Individuals with PTSD often suffer from flashbacks, nightmares, and severe anxiety, which can lead them to engage in self-injury behaviors. […] However, self-injury can worsen PTSD symptoms and increase the risk of suicidal behaviors. […] A study that analyzed the relationship between NSSI and eating disorders found up to 42% of people with anorexia and as much as 55% of those with bulimia engaged in self-harming behaviors. […] Self-harm is not unusual for people who have this severe mental illness. […] Suicidal ideation is also very common in this condition and 20% of people who are schizophrenic will attempt suicide at least once. […] Therefore, it is not surprising that self-harming behaviors are also found in some people who struggle with alcohol or substance abuse, which by their inherent nature, exacerbate underlying psychiatric symptoms.

• #82 Self injury, self harm and PTSD – PTSD UK

  https://www.ptsduk.org/self-injury-self-harm-and-ptsd/

  There is growing evidence showing a link between Post Traumatic Stress Disorder, and what is collectively known as self-injurious behaviours (SIB). […] Self-harm is sometimes referred to as non-suicidal self-injury (or NSSI). It involves damaging yourself without an intention to end your life. […] Though statistics vary, it is clear that having Post Traumatic Stress Disorder does increase the likelihood of self-harming behaviours, including substance misuse and the type of injuries listed above. […] This is why it is seen as an early indicator of undiagnosed PTSD. […] A feature of both PTSD and C-PTSD is being in a constant state of alarm, hypervigilant to danger, and anxious. […] The NHS signposts people to help with self-harming, though tackling underlying conditions like post-traumatic stress disorder is a vital first step.

• #83 Self-harm and autism | Autistica

  https://www.autistica.org.uk/what-is-autism/anxiety-and-autism-hub/self-harm-and-autism

  Your doctor may be able to offer you options, which may help you feel better about aspects of your life that feel difficult at the moment and might be triggering you to you want to self-harm. […] Up to 50% of autistic people have self-harmed. […] Mental health issues affect 79% of autistic adults, but many do not get the help and support they need.

• #84 Self-harm and autism | Autistica

  https://www.autistica.org.uk/what-is-autism/anxiety-and-autism-hub/self-harm-and-autism

  Self-harm is when a person deliberately injures themselves. The methods used to cause the injury can take many forms. It has been reported that up to half of autistic people show self-harming behaviour. […] Many autistic people find it difficult to recognise, manage and express their emotions. This is known as alexithymia. It can mean that autistic people who experience alexithymia are more likely to feel frustrated, anxious and depressed, and less able to effectively cope with these emotions. Higher levels of alexithymia are linked to higher levels of self-harm in autistic people. […] Some people worry that people who self-harm are suicidal. Research with autistic adults has shown that some people who self-harm have no intention of killing themselves. Self-harm does not necessarily correspond with desire to die, but research suggests it may be linked to a greater risk of suicide in future. For this reason, its important to take self-harm seriously.

• #85 7 Common Self-Harm Conditions Linked to Suicide | Amen Clinics Amen Clinics

  https://www.amenclinics.com/blog/7-psychiatric-conditions-linked-to-self-harm-and-suicide/

  Individuals with PTSD often suffer from flashbacks, nightmares, and severe anxiety, which can lead them to engage in self-injury behaviors. […] However, self-injury can worsen PTSD symptoms and increase the risk of suicidal behaviors. […] A study that analyzed the relationship between NSSI and eating disorders found up to 42% of people with anorexia and as much as 55% of those with bulimia engaged in self-harming behaviors. […] Self-harm is not unusual for people who have this severe mental illness. […] Suicidal ideation is also very common in this condition and 20% of people who are schizophrenic will attempt suicide at least once. […] Therefore, it is not surprising that self-harming behaviors are also found in some people who struggle with alcohol or substance abuse, which by their inherent nature, exacerbate underlying psychiatric symptoms.

• #86 Top Psychiatric Disorders Most at Risk for Self-Injury 

  https://mypsychiatrist.com/blog/psychiatric-disorders-at-risk-for-self-injury/

  Typical forms of self-harm include cutting, bruising, head banging, and biting. […] The constant negativity encourages self-harming because the person feels undeserving, unqualified, or a fake. […] The depressive mood comes with an overwhelmingly negative attitude and perception of life. […] Self-harm functions as an escape from the mental anguish and emotional distress experienced by the person. […] Depressed women, youth, and adolescents are more likely to indulge in non-suicidal self-injury and attempt suicide than men. […] Substance use disorder is a maladaptive habit in many psychiatric conditions. It is no surprise that it pushes people to self-harm. […] The negative effects push addicts into self-injury to release the pent-up mental tension, severe depression, and anguish. […] At My Psychiatrist, we understand that self-injury can be an expression of intense emotional distress and a way to cope with unbearable feelings.

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