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Nonsuicidal Self-injury in Children and Adolescents

摘要


Background: Nonsuicidal self-injury (NSSI), self-harm behavior without suicidal intent, is a serious problem that is prevalent among adolescents. The fact that NSSI is listed as "condition for further study" in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, indicates that its severity is recognized in clinical medicine. Methods: In this paper, we review the recent literature on the risk factors for NSSI, as well as its epidemiology, etiology, risk factors, and treatment. Results: The prevalence of NSSI in adolescents is about 17%-18%. Notably, it is more common in girls. In psychiatric units, the reported rate of NSSI among adolescents is 60%. Considered a strategy by which adolescents blanket their emotional discomfort with physical pain, NSSI may increase the risk of developing psychiatric disorders and involve physical sequelae. NSSI has many etiologies and risk factors, including interpersonal problems, social contagion, adverse childhood experiences, and neurobiological factors. No definite evidence supports the psychopharmacological treatment of NSSI in adolescence. Recent studies showed that dialectical behavioral therapy, cognitive behavioral therapy, and mentalization-based treatment have therapeutic effects in adolescent patients with NSSI. Conclusion: NSSI is highly prevalent and highly comorbid with other psychiatric disorders. To prevent and manage this problem more effectively, further research on and understanding of the etiological characteristics is warranted.

參考文獻


Lloyd-Richardson EE, Perrine N, Dierker L, et al.: Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychol Med 2007; 37: 1183-92.
American Psychiatric Association: The Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. Washington DC, USA: American Psychiatric Association, 2013.
Zetterqvist M: The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature. Child Adolesc Psychiatry Ment Health 2015; 9: 31.
Plener PL, Schumacher TS, Munz LM, et al.: The longitudinal course of non-suicidal self-injury and deliberate self-harm: a systematic review of the literature. Borderline Personal Disord Emot Dysregul 2015; 2: 2.
Sornberger MJ, Heath NL, Toste JR, et al.: Nonsuicidal self-injury and gender: patterns of prevalence, methods, and locations among adolescents. Suicide Life Threat Behav 2012; 42: 266-78.

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