Nonsuicidal Self-Injury of Adolescents

Abstract

Nonsuicidal self-injury (NSSI) is more common in adolescent and young adult populations than in the past. NSSI is typically used to deal with distressing negative affective states, especially anger and depression, and mixed emotional states. Pediatricians; primary care, family medicine, and emergency room physicians; and mental health professionals are faced with the charge of responding to NSSI behaviors among patients. Physicians in family medicine, pediatrics, and primary care settings play an essential role in initiating the beginning step in the treatment process for those who self-injure. All providers can strengthen the care provided to those who engage in NSSI via assessing the risk accurately, understanding the functions of the behavior, and assisting the patient in connecting with treatment. This article provides medical and mental health professionals with an overview of intervention strategies that may be useful when counseling adolescents and their families. In addition, areas for continued research are discussed.

Characteristics of children and adolescents presenting to the emergency department with self-inflicted injury: Retrospective analysis of two teaching hospitals

“…Visit-related descriptors included arrival time, whether the child arrived via ambulance, triggers of self-inflicted injury, mechanisms of self-harm, whether the child had suicidal ideation, and disposition classified as either admission to a psychiatric ward, discharge from emergency department, or discharge against medical advice. Triggers for selfinflicted injury were classified into the following categories as described previously 8,9 : interpersonal relationship issues (being angry at someone, wanted to get back at someone); depressive or psychotic symptoms (feeling bored, unhappy, depressed, experiencing delusions or hallucinations); desire to draw attention or express need (wanted to be noticed, wanted others to see my desperation, wanted to avoid having to do something); academic problems (feeling stressed about school, unhappy with performance at school); employment or finance issues (feeling stressed about work, economic hardships); victim of an accusation; or no identified trigger. Multiple mechanisms of injury was defined as more than one intentional injury inflicted within 24 h between each other on arrival at the emergency department.…”

Parental attachment and childhood trauma in adolescents engaged in non‐suicidal self‐injury

“…Clinical studies have discussed multiple associated factors of NSSI include psychological characteristics (such as negative emotionality, deficit in emotion skills, self‐derogation), psychiatric disorders, childhood environmental factors and advertises (Klonsky, 2007). Considering psychological factors, the studies have found that early‐life traumatic events can influence on need to engage self‐injury via managing stress abilities and emotion regulation (Lovell & Clifford, 2016). A systematic review has shown that childhood maltreatment is a significant risk factor for NSSI (Serafini et al, 2017).…”

The relationship between nonsuicidal self-injurious behavior and manners of death: a multicenter autopsy study

“…Many psychiatric studies from developed countries reported a relationship between attempted suicide and NSSIB. Similarly, numerous psychiatric disorders including depression, anxiety, behavioral disorders, drug abuse, and dissociative, borderline, and antisocial personality disorders are associated with NSSIB and suicidal behavior (4,6,(13)(14)(15)(19)(20)(21)(22)(23)(24)(25). There is no autopsy study in the literature about this relationship.…”