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==Classification==
==Classification==
[[File:NSSI.jpg|thumb|Non Suicidal Self Injury]]
[[File:NSSI.jpg|thumb|Non Suicidal Self Injury]]
The Non Suicidal Self Injury also known as Self Harm, [[Self Injury]], Self-inflicted violence, Self Injurious [[Behavior]]. These are the common term used interchangeably by various [[Authorship guidelines|authors]] and practioners to name the [[disease]]. The [[behavior]] entails [[Intentional stance|intentional]] [[tissue]] [[injury]] that is usually carried out without a [[suicidal]] motive. Cutting the [[skin]] with a [[Sharps waste|sharp]] item, such as a knife or razor blade, is the most prevalent type of [[self-harm]]. The word "self-mutilation" is also occasionally used, albeit it has connotations that some people find alarming, inaccurate, or unpleasant.
The Non [[Suicidal]] [[Self-injury|Self Injury]] also known as [[Self-harm]], [[Self Injury]], Self-inflicted violence, Self Injurious [[Behavior]]. <ref name="urlAPA PsycNet">{{cite web |url=https://doi.org/10.1037/11875-001 |title=APA PsycNet |format= |work= |accessdate=}}</ref> These are the common term used interchangeably by various [[Authorship guidelines|authors]] and practioners to name the [[disease]]. The [[behavior]] entails [[Intentional stance|intentional]] [[tissue]] [[injury]] that is usually carried out without a [[suicidal]] motive. [[Cutting balloon|Cutting]] the [[skin]] with a [[Sharps waste|sharp]] item, such as a knife or razor blade, is the most prevalent type of [[self-harm]]. The word "self-mutilation" is also occasionally used, albeit it has connotations that some people find alarming, inaccurate, or unpleasant.
Soldiers use the term "self-inflicted wounds" to describe non-lethal injuries they cause in order to be released from combat sooner. But this damage is inflicted for a defined secondary aim, which differs from the standard definition of self-harm. we can also say the people who injure their bodies through disordered eating may be included in the definition of self-harm when broader aspect of the disease is considered.
Soldiers use the term "self-inflicted wounds" to describe non-lethal [[injuries]] they cause in order to be released from combat sooner. But this damage is inflicted for a [[Defined Daily Doses|defined]] [[secondary]] aim, which differs from the [[standard]] [[Definition of life|definition]] of [[self-harm]]. We can also say the [[People's Solidarity|people]] who [[Injured reserve list|injure]] their bodies through [[disordered eating]] may be included in the [[Definition of life|definition]] of [[self-harm]] when broader aspect of the [[disease]] is considered.
NSSI has been proposed as a disorder in the DSM-5's "Conditions for Further Study" category. It should be noted that this proposed diagnostic criteria for a future diagnosis is not an officially approved diagnosis and should not be utilized in clinical practice; rather, it is intended solely for research purposes. The NSSI is classified as deliberate self-inflicted harm without the intent to commit suicide. The criteria for diagnosing and identifying NSSI includes 5 or more days of self inflicted harm over the duration of one year without having any intention to commit the suicide and along with that the person must have been having a motivation to relief from the negative state or to achieve a positive state.
NSSI has been proposed as a [[disorder]] in the [[DSM]]-5's "Conditions for Further Study" category. It should be noted that this proposed [[diagnostic criteria]] for a [[Future Directions|future]] [[diagnosis]] is not an officially [[Approved drug|approved]] [[diagnosis]] and should not be utilized in [[Clinical practice guideline|clinical practice]]; rather, it is intended solely for [[research]] purposes. The NSSI is classified as deliberate self-inflicted [[Harm minimization|harm]] without the [[Intent to treat|intent]] to commit [[suicide]]. The [[criteria]] for diagnosing and identifying NSSI includes 5 or more days of self inflicted harm over the duration of one year without having any [[Intentionality|intention]] to commit the [[suicide]] and along with that the person must have been having a motivation to relief from the negative state or to achieve a positive state.
Self-harm is commonly misunderstood as an attention-seeking behavior; however, this is not always the case. Many self-harmers are self-conscious about their scars and wounds, and they feel bad about their actions, therefore they go to great measures to hide their actions from others. They try to give the alternate reasoning for their scars or try to hide them with clothing. Self-harmers aren't usually trying to take their own lives; instead, it's thought that they're using it as a coping method to ease emotional anguish or discomfort, or as a way to communicate their distress.
[[Self-harm]] is commonly misunderstood as an attention-seeking [[behavior]]; however, this is not always the case. Many self-harmers are [[Self-consciousness|self-conscious]] about their [[scars]] and wounds, and they feel bad about their actions, therefore they go to great [[Average|measures]] to hide their actions from others. They try to give the alternate [[reasoning]] for their [[scars]] or try to hide them with clothing. [[Self-harm]]<nowiki/>ers aren't usually trying to take their own lives; instead, it's thought that they're using it as a [[Coping strategies|coping]] method to ease [[emotional]] anguish or [[discomfort]], or as a way to communicate their distress.
Self-harm is dependent on environmental circumstances such as receiving attention or escaping expectations, according to studies of people with developmental disabilities (such as intellectual disability). Some people suffer from dissociation because they want to feel authentic or fit to society's rules.
[[Self-harm]] is dependent on [[Environmental epidemiology|environmental]] circumstances such as receiving [[attention]] or escaping [[expectation]]<nowiki/>s, according to studies of people with [[developmental]] disabilities (such as [[intellectual disability]]). Some people suffer from [[Dissociation (psychology)|dissociation]] because they want to feel [[Authentic Movement|authentic]] or fit to society's rules.
==Pathophysiology==
==Pathophysiology==
[[Emotional]] and [[Physical examination|physical pain]] activates the same regions of the [[brain]] which in some [[People's Solidarity|people]] is the [[Reasoning|reason]] for the intolerance of [[emotional stress]]. Some of this is [[Attributable risk|attributable]] to [[Environmental science|environmental]], while others are caused by [[Physiological|physiologica]]<nowiki/>l [[Response rate|variations in response.]] <ref name="pmid19830534">{{cite journal |vauthors=Ballard E, Bosk A, Pao M |title=Invited commentary: understanding brain mechanisms of pain processing in adolescents' non-suicidal self-injury |journal=J Youth Adolesc |volume=39 |issue=4 |pages=327–34 |date=April 2010 |pmid=19830534 |doi=10.1007/s10964-009-9457-1 |url=}}</ref><ref name="pmid10974364">{{cite journal |vauthors=Bohus M, Limberger M, Ebner U, Glocker FX, Schwarz B, Wernz M, Lieb K |title=Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behavior |journal=Psychiatry Res |volume=95 |issue=3 |pages=251–60 |date=September 2000 |pmid=10974364 |doi=10.1016/s0165-1781(00)00179-7 |url=}}</ref><ref name="pmid9809120">{{cite journal |vauthors=Briere J, Gil E |title=Self-mutilation in clinical and general population samples: prevalence, correlates, and functions |journal=Am J Orthopsychiatry |volume=68 |issue=4 |pages=609–20 |date=October 1998 |pmid=9809120 |doi=10.1037/h0080369 |url=}}</ref><ref name="pmid18576203">{{cite journal |vauthors=Deliberto TL, Nock MK |title=An exploratory study of correlates, onset, and offset of non-suicidal self-injury |journal=Arch Suicide Res |volume=12 |issue=3 |pages=219–31 |date=2008 |pmid=18576203 |doi=10.1080/13811110802101096 |url=}}</ref><ref name="pmid16890354">{{cite journal |vauthors=Eisenberger NI, Jarcho JM, Lieberman MD, Naliboff BD |title=An experimental study of shared sensitivity to physical pain and social rejection |journal=Pain |volume=126 |issue=1-3 |pages=132–8 |date=December 2006 |pmid=16890354 |doi=10.1016/j.pain.2006.06.024 |url=}}</ref><ref name="pmid15242688">{{cite journal |vauthors=Eisenberger NI, Lieberman MD |title=Why rejection hurts: a common neural alarm system for physical and social pain |journal=Trends Cogn Sci |volume=8 |issue=7 |pages=294–300 |date=July 2004 |pmid=15242688 |doi=10.1016/j.tics.2004.05.010 |url=}}</ref>
The [[autonomic nervous system]] is composed of
*[[File:Pathophysiology of Non Suicidal Self Injury (2).jpg|alt=Pathophysiology.|center|thumb|529x529px|Pathophysiology of Non Suicidal Self Injury]][[Emotional]] and [[Physical examination|physical pain]] activates the same regions of the [[brain]] which in some [[People's Solidarity|people]] is the [[Reasoning|reason]] for the intolerance of [[emotional stress]]. Some of this is [[Attributable risk|attributable]] to [[Environmental science|environmental]], while others are caused by [[Physiological|physiologica]]<nowiki/>l [[Response rate|variations in response.]] <ref name="pmid19830534">{{cite journal |vauthors=Ballard E, Bosk A, Pao M |title=Invited commentary: understanding brain mechanisms of pain processing in adolescents' non-suicidal self-injury |journal=J Youth Adolesc |volume=39 |issue=4 |pages=327–34 |date=April 2010 |pmid=19830534 |doi=10.1007/s10964-009-9457-1 |url=}}</ref><ref name="pmid10974364">{{cite journal |vauthors=Bohus M, Limberger M, Ebner U, Glocker FX, Schwarz B, Wernz M, Lieb K |title=Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behavior |journal=Psychiatry Res |volume=95 |issue=3 |pages=251–60 |date=September 2000 |pmid=10974364 |doi=10.1016/s0165-1781(00)00179-7 |url=}}</ref><ref name="pmid9809120">{{cite journal |vauthors=Briere J, Gil E |title=Self-mutilation in clinical and general population samples: prevalence, correlates, and functions |journal=Am J Orthopsychiatry |volume=68 |issue=4 |pages=609–20 |date=October 1998 |pmid=9809120 |doi=10.1037/h0080369 |url=}}</ref><ref name="pmid18576203">{{cite journal |vauthors=Deliberto TL, Nock MK |title=An exploratory study of correlates, onset, and offset of non-suicidal self-injury |journal=Arch Suicide Res |volume=12 |issue=3 |pages=219–31 |date=2008 |pmid=18576203 |doi=10.1080/13811110802101096 |url=}}</ref><ref name="pmid16890354">{{cite journal |vauthors=Eisenberger NI, Jarcho JM, Lieberman MD, Naliboff BD |title=An experimental study of shared sensitivity to physical pain and social rejection |journal=Pain |volume=126 |issue=1-3 |pages=132–8 |date=December 2006 |pmid=16890354 |doi=10.1016/j.pain.2006.06.024 |url=}}</ref><ref name="pmid15242688">{{cite journal |vauthors=Eisenberger NI, Lieberman MD |title=Why rejection hurts: a common neural alarm system for physical and social pain |journal=Trends Cogn Sci |volume=8 |issue=7 |pages=294–300 |date=July 2004 |pmid=15242688 |doi=10.1016/j.tics.2004.05.010 |url=}}</ref>
The [[sympathetic nervous system]]- controls [[arousal]] and [[Physical activity|physical]] [[Activation energy|activation]].
The [[parasympathetic nervous system]]-controls [[Automaticity|automatic]] [[Physical activity|physical]] activation.
Self-injuring adolescents exhibit higher [[physiological]] [[Response element|response]] to [[stress]] (e.g., skin conductance) than non self-injuring adolescents. Over time this [[stress response]] stays same and sometimes it even increases.
[[Self-harm]]<nowiki/>ers think that [[self-injury]] can lead to relief. For some, relief comes largely from [[Psychological factors affecting other medical conditions|psychological factors]], whereas for others, it comes through the release of [[Beta-1|beta]] [[endorphins]] in the [[brain]]. [[Endorphins]] are [[endogenous]] [[opioids]] that are released in [[reaction]] to [[Physical activity|physical]] damage, functioning as natural [[analgesics]] and producing pleasurable sensations, and would also be released in response to self-harm, reducing tension and mental anguish.
*Self-injuring adolescents exhibit higher [[physiological]] [[Response element|response]] to [[stress]] (e.g., skin conductance) than non self-injuring adolescents. Over time this [[stress response]] stays same and sometimes it even increases.
Self-harm may become psychologically addictive as a coping technique because it allows the self harmers to deal with extreme stress in the present moment. Its patterns, such as particular time intervals between acts of self-harm, can also result in a behavioural pattern that leads to a desire or urge to act on self-harming ideas.
*[[Self-harm]]<nowiki/>ers think that [[self-injury]] can lead to relief. For some, relief comes largely from [[Psychological factors affecting other medical conditions|psychological factors]], whereas for others, it comes through the release of [[Beta-1|beta]] [[endorphins]] in the [[brain]]. [[Endorphins]] are [[endogenous]] [[opioids]] that are released in [[reaction]] to [[Physical activity|physical]] damage, functioning as natural [[analgesics]] and producing pleasurable [[sensations]], and would also be released in [[Response element|response]] to [[self-harm]], reducing [[tension]] and [[mental]] anguish. [[Self-harm]] may become [[psychologically]] [[addictive]] as a [[Coping (psychology)|coping]] technique because it allows the self harmers to deal with extreme [[anxiety]], [[stress]], [[depression]], [[emotional]] [[numbness]], and a [[sense]] of self-loathing or [[failure]]. in the present moment. Its patterns, such as particular [[Time balance|time]] intervals between acts of [[self-harm]], can also result in a [[behavioural]] [[pattern]] that leads to a [[desire]] or urge to act on [[self-harm]]<nowiki/>ing ideas.
Self-injury has a wide range of reasons since it may be utilized to accomplish a variety of goals. It is used as a coping technique for severe feelings including anxiety, stress, depression, emotional numbness, and a sense of self-loathing or failure. Professional evaluations are more likely to imply manipulative or punitive intentions than personal evaluations.
*Many persons who [[self-harm]] claim that it permits them to "get away" or "dissociate," removing their minds from [[painful]] [[sensations]]. This can be accomplished by convincing the [[mind]] that the [[current]] suffering is due to the [[self-harm]] rather than the difficulties they were dealing with previously: the [[Physical activity|physical]] [[pain]] serves as a [[Diversional therapy|diversion]] from the initial [[mental]] agony.To add to this notion, one can think how important it is to "[[Stops|stop]]" [[feeling]] [[emotional]] anguish and [[mental]] irritation. "A person may be [[hypersensitive]] and overloaded, with a [[plethora]] of thoughts [[whirling]] about in their heads, and they may get triggered or may decide to stop the overpowering [[sensations]]."
Two motivations were mentioned in the UK ONS study: "because of anger" and "to grab attention".
*Alternatively, [[self-harm]], on the other [[hand]], might be a way of [[feeling]] something, even if it's [[Unpleasant taste in the mouth|unpleasant]] and [[Painful|painfu]]<nowiki/>l. [[Anhedonia]] is a sense of emptiness or [[numbness]] experienced by those who [[self-harm]], and [[Physical examination|physical]] [[pain]] may provide relief from these [[feeling]]<nowiki/>s. "A [[person]] might be aloof from oneself, aloof from [[life]], numb and unfeeling."They develop a [[desire]] to [[Feeling|feel]] something, and try to create a sesation and "wake up".
Many persons who self-harm claim that it permits them to "get away" or "dissociate," removing their minds from painful sensations. This can be accomplished by convincing the mind that the current suffering is due to the self-harm rather than the difficulties they were dealing with previously: the physical pain serves as a diversion from the initial mental agony.To add to this notion, one can think how important it is to "stop" feeling emotional anguish and mental irritation. "A person may be hypersensitive and overloaded, with a plethora of thoughts whirling about in their heads, and they may get triggered or may decide to stop the overpowering sensations."
Alternatively, self-harm, on the other hand, might be a way of feeling something, even if it's unpleasant and painful. Anhedonia is a sense of emptiness or numbness experienced by those who self-harm, and physical pain may provide relief from these feelings. "A person might be aloof from oneself, aloof from life, numb and unfeeling."They develop a desire to feel something, and try to create a sesation and "wake up".
==Causes==
==Causes==
Self-injury is a complicated condition without any simple explanation. Most people use it as a coping mechanism to deal with the feelings of unreality or numbness, to express distressful emotions, to punish themselves, to stop flashbacks and to relieve tension.<ref name="pmid20180727">{{cite journal |vauthors=Joyce PR, Light KJ, Rowe SL, Cloninger CR, Kennedy MA |title=Self-mutilation and suicide attempts: relationships to bipolar disorder, borderline personality disorder, temperament and character |journal=Aust N Z J Psychiatry |volume=44 |issue=3 |pages=250–7 |date=March 2010 |pmid=20180727 |doi=10.3109/00048670903487159 |url=}}</ref><ref name="pmid19813111">{{cite journal |vauthors=Rossow I, Hawton K, Ystgaard M |title=Cannabis use and deliberate self-harm in adolescence: a comparative analysis of associations in England and Norway |journal=Arch Suicide Res |volume=13 |issue=4 |pages=340–8 |date=2009 |pmid=19813111 |doi=10.1080/13811110903266475 |url=}}</ref><ref name="pmid19415088">{{cite journal |vauthors=Urnes O |title=[Self-harm and personality disorders] |language=Norwegian |journal=Tidsskr Nor Laegeforen |volume=129 |issue=9 |pages=872–6 |date=April 2009 |pmid=19415088 |doi=10.4045/tidsskr.08.0140 |url=}}</ref><ref name="pmid3167380">{{cite journal |vauthors=Humphries SR |title=Munchausen syndrome. Motives and the relation to deliberate self-harm |journal=Br J Psychiatry |volume=152 |issue= |pages=416–7 |date=March 1988 |pmid=3167380 |doi=10.1192/bjp.152.3.416 |url=}}</ref><ref name="pmid17967920">{{cite journal |vauthors=Johnson CP, Myers SM |title=Identification and evaluation of children with autism spectrum disorders |journal=Pediatrics |volume=120 |issue=5 |pages=1183–215 |date=November 2007 |pmid=17967920 |doi=10.1542/peds.2007-2361 |url=}}</ref>
[[Self-injury]] is a complicated [[condition]] without any simple [[explanation]]. Most people use it as a [[Coping (psychology)|coping]] [[Mechanism (biology)|mechanism]] to deal with the [[feelings]] of unreality or [[numbness]], to [[Expression|express]] distressful [[emotions]], to punish themselves, to [[Stops|stop]] flashbacks and to relieve [[tension]].<ref name="pmid20180727">{{cite journal |vauthors=Joyce PR, Light KJ, Rowe SL, Cloninger CR, Kennedy MA |title=Self-mutilation and suicide attempts: relationships to bipolar disorder, borderline personality disorder, temperament and character |journal=Aust N Z J Psychiatry |volume=44 |issue=3 |pages=250–7 |date=March 2010 |pmid=20180727 |doi=10.3109/00048670903487159 |url=}}</ref><ref name="pmid19813111">{{cite journal |vauthors=Rossow I, Hawton K, Ystgaard M |title=Cannabis use and deliberate self-harm in adolescence: a comparative analysis of associations in England and Norway |journal=Arch Suicide Res |volume=13 |issue=4 |pages=340–8 |date=2009 |pmid=19813111 |doi=10.1080/13811110903266475 |url=}}</ref><ref name="pmid19415088">{{cite journal |vauthors=Urnes O |title=[Self-harm and personality disorders] |language=Norwegian |journal=Tidsskr Nor Laegeforen |volume=129 |issue=9 |pages=872–6 |date=April 2009 |pmid=19415088 |doi=10.4045/tidsskr.08.0140 |url=}}</ref><ref name="pmid3167380">{{cite journal |vauthors=Humphries SR |title=Munchausen syndrome. Motives and the relation to deliberate self-harm |journal=Br J Psychiatry |volume=152 |issue= |pages=416–7 |date=March 1988 |pmid=3167380 |doi=10.1192/bjp.152.3.416 |url=}}</ref><ref name="pmid17967920">{{cite journal |vauthors=Johnson CP, Myers SM |title=Identification and evaluation of children with autism spectrum disorders |journal=Pediatrics |volume=120 |issue=5 |pages=1183–215 |date=November 2007 |pmid=17967920 |doi=10.1542/peds.2007-2361 |url=}}</ref>
Common causes of Non Suicidal Self Injury
Common causes of Non [[Suicidal]] [[Self Injury]]
*Psychological factors: Abuse during childhood, troubled relationships with parents or partner, bereavement. Lack of belonging, considering oneself as a burden, feelings of entrapment,defeat, with the onset of pubertal period and sexual activity because of neurodevelopmental vulnerability. Associated with autism spectrum disorders, borderline personality disorder. As an experience of dissociative state and depersonalisation. Unemployment, war and poverty are other contributing factors.
*[[Psychological factors affecting other medical conditions|Psychological factors]]: [[Abuse]] during [[childhood]], troubled relationships with parents or partner, [[bereavement]]. Lack of belonging, considering oneself as a burden, [[feelings]] of entrapment,defeat, with the onset of [[Pubertal|puberta]]<nowiki/>l [[period]] and [[sexual activity]] because of [[Neurodevelopmental disorders|neurodevelopmental]] vulnerability. Associated with [[autism spectrum disorder]]<nowiki/>s, [[borderline personality disorder]]. As an experience of [[dissociative]] state and [[depersonalisation]]. Unemployment, war and poverty are other contributing factors.
*Mental disorder:The mental illnesses which have an increased associated risk of self-injury are depression, dissociative disorders, borderline personality disorder, autism spectrum disorders, bipolar disorder, conduct disorders and phobias. OCD, PTSD, Schizophrenia, Substance abuse, poor problem-solving skills and impulsivity, Münchausen syndrome. Eating disoreds and anxiety disorders.
*[[Mental disorder]]:The [[mental illnesses]] which have an increased associated [[Risk-benefit analysis|risk]] of [[self-injury]] are [[depression]], [[dissociative disorders]], [[borderline personality disorder]], [[autism spectrum disorder]]<nowiki/>s, [[bipolar disorder]], [[conduct disorders]] and [[phobias]]. [[OCD]], [[Post traumatic stress disorder|PTSD]], [[Schizophrenia]], [[Substance abuse]], poor problem-solving skills and [[impulsivity]], [[Münchausen syndrome]]. [[Eating disorders]] and [[anxiety disorders]].
*Genetics: The rare genetic condition, Lesch–Nyhan syndrome is characterised by self harm which includes biting and head-banging. Genetics is involved in the development of psychological conditions such as anxiety and depression which may contribute to self-injuring behaviour.
*[[Genetics]]: The [[rare]] [[genetic condition]], Lesch–Nyhan syndrome is characterised by [[self harm]] which includes biting and head-banging. [[Genetics]] is involved in the development of [[psychological]] [[conditions]] such as [[anxiety]] and [[depression]] which may contribute to [[Self-injury|self-injur]]<nowiki/>ing [[behaviour]].
*Drugs and alcohol: Self-harm is linked to chronic substance abuse, dependency, and withdrawal.
*[[Drugs]] and [[alcohol]]: [[Self-harm]] is linked to [[chronic]] [[substance abuse]], [[Dependency ratio|dependency]], and [[withdrawal]].
*Benzodiazepine dependence as well as benzodiazepine withdrawal.
*[[Benzodiazepine]] dependence as well as [[benzodiazepine withdrawal]].
*Alcohol addiction.
*[[Alcohol]] [[addiction]].
*Cannabis use and intentional self-injury.
*[[Cannabis]] use and [[Intentionality|intentional]] [[self-injury]].
*Smoking
*[[Smoking]]
==Differentiating Nonsuicidal self-injury from other Diseases==
==Differentiating Nonsuicidal self-injury from other Diseases==
{| class="wikitable"
{| class="wikitable"
|+Differential diagnosis of Nonsuicidal self-injury
|+Differential diagnosis of Nonsuicidal self-injury<ref name="urlRedirecting">{{cite web |url=https://doi.org/10.1016/j.amjmed.2005.09.027 |title=Redirecting |format= |work= |accessdate=}}</ref><ref name="urlDSM-5">{{cite web |url=https://www.psychiatry.org/psychiatrists/practice/dsm |title=DSM-5 |format= |work= |accessdate=}}</ref><ref name="pmid7802127">{{cite journal |vauthors=Foa EB, Kozak MJ, Goodman WK, Hollander E, Jenike MA, Rasmussen SA |title=DSM-IV field trial: obsessive-compulsive disorder |journal=Am J Psychiatry |volume=152 |issue=1 |pages=90–6 |date=January 1995 |pmid=7802127 |doi=10.1176/ajp.152.1.90 |url=}}</ref>
|-
|-
!Header text!!Header text
!Name of the condition!!Characteristic features
|-
|-
|Post-traumatic Stress disorder||Example
|Post-traumatic Stress disorder||Reliving the [[Incident report|incident]] with distressing recollections, [[Flashback (psychological phenomenon)|flashback]]<nowiki/>s, [[dream]]<nowiki/>s, and/or [[Physical activity|physical]] and [[psychological]] distress, [[Avoidance reaction|avoidance]] of events that might trigger experiences or [[memories]] of the [[trauma]], and increased [[arousal]].
|-
|-
|Dissociative disorder||Example
|[[Dissociative disorder]]||An unintentional [[Escape reflex|escape]] from reality characterized by separation between [[Identity (social science)|identity]], thoughts, [[memory]] and awareness.
|-
|-
|Obsessive-compulsive disorder||Example
|[[Obsessive-compulsive disorder]]||[[Obsession]]<nowiki/>s which are repetitive and persistent urges, thoughts or [[Images page|images]] followed by compulsions which are repetitive behaviors or [[mental]] acts that the individual [[Feeling|feel]]<nowiki/>s driven to perform.
|-
|-
|Conduct disorder||Example
|[[Conduct disorder]]||Deceitfulness and theft, destruction of property, aggression against people and [[animals]], and serious violations of rules.
|-
|-
|Intermittent explosive disorder||Example
|[[Intermittent explosive disorder]]||Unable to stop impulses which leads to [[Physical activity|physical]] and [[Verbal behavior|verbal]] aggression. These are out of proportion to the provocation, unplanned and cause [[Subjective logic|subjective]] and [[psychosocial]] distress.
|-
|-
|Anxiety and mood disorder||Example
|[[Substance use disorder]]||Use of [[tobacco]], [[alcohol]], and/or legal and illegal [[drugs]] causes [[disability]], health problems,or failure to meet major responsibilities at work, school or home. Leads to problems with [[Social (pragmatic) communication disorder|social]] interactions, impaired control, and risky [[behaviors]].
|-
|-
|Substance use disorder||Example
|[[Bulimia Nervosa|Bulimia]]||Consuming huge amounts of food while losing control of one's [[appetite]] and then attempting to burn off the excess [[calories]] in an unhealthy manner.
|-
|-
|Bulimia||Example
|[[Dissociative identity disorder]]||The existence of two or more [[Distinctive feature|distinct]] [[personality]] states, as well as repeated gaps in [[recollection]] of personal information or experiences, characterizes identity disruption.
|-
|Dissociative identity disorder||Example
|-
|Example||Example
|}
|}
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==Epidemiology and Demographics==
==Epidemiology and Demographics==
*The [[prevalence]] of NSSI varies between 7.5 and 46.5 percent in teenagers, rising to 38.9 percent among students and 4–23% among adults. Despite the fact that self-injurious behaviour is a common occurrence, results from different studies differ significantly.<ref name="pmid9809120">{{cite journal |vauthors=Briere J, Gil E |title=Self-mutilation in clinical and general population samples: prevalence, correlates, and functions |journal=Am J Orthopsychiatry |volume=68 |issue=4 |pages=609–20 |date=October 1998 |pmid=9809120 |doi=10.1037/h0080369 |url=}}</ref><ref name="pmid6887199">{{cite journal |vauthors=Archer S, Zayed AH, Rej R, Rugino TA |title=Analogues of hycanthone and lucanthone as antitumor agents |journal=J Med Chem |volume=26 |issue=9 |pages=1240–6 |date=September 1983 |pmid=6887199 |doi=10.1021/jm00363a007 |url=}}</ref><ref name="pmid9809120">{{cite journal |vauthors=Briere J, Gil E |title=Self-mutilation in clinical and general population samples: prevalence, correlates, and functions |journal=Am J Orthopsychiatry |volume=68 |issue=4 |pages=609–20 |date=October 1998 |pmid=9809120 |doi=10.1037/h0080369 |url=}}</ref><ref name="pmid17178643">{{cite journal |vauthors=Muehlenkamp JJ, Gutierrez PM |title=Risk for suicide attempts among adolescents who engage in non-suicidal self-injury |journal=Arch Suicide Res |volume=11 |issue=1 |pages=69–82 |date=2007 |pmid=17178643 |doi=10.1080/13811110600992902 |url=}}</ref><ref name="pmid22435988">{{cite journal |vauthors=Sornberger MJ, Heath NL, Toste JR, McLouth R |title=Nonsuicidal self-injury and gender: patterns of prevalence, methods, and locations among adolescents |journal=Suicide Life Threat Behav |volume=42 |issue=3 |pages=266–78 |date=June 2012 |pmid=22435988 |doi=10.1111/j.1943-278X.2012.0088.x |url=}}</ref><ref name="pmid22880967">{{cite journal |vauthors=Kuentzel JG, Arble E, Boutros N, Chugani D, Barnett D |title=Nonsuicidal self-injury in an ethnically diverse college sample |journal=Am J Orthopsychiatry |volume=82 |issue=3 |pages=291–7 |date=July 2012 |pmid=22880967 |doi=10.1111/j.1939-0025.2012.01167.x |url=}}</ref><ref name="pmid26114574">{{cite journal |vauthors=Wan Y, Chen J, Sun Y, Tao F |title=Impact of Childhood Abuse on the Risk of Non-Suicidal Self-Injury in Mainland Chinese Adolescents |journal=PLoS One |volume=10 |issue=6 |pages=e0131239 |date=2015 |pmid=26114574 |pmc=4482708 |doi=10.1371/journal.pone.0131239 |url=}}</ref>
*The [[prevalence]] of NSSI varies between 7.5 and 46.5 percent in teenagers, rising to 38.9 percent among students and 4–23% among adults. Despite the fact that [[Self-injury|self-injur]]<nowiki/>ious [[behaviour]] is a common occurrence, results from different studies differ significantly.<ref name="pmid9809120">{{cite journal |vauthors=Briere J, Gil E |title=Self-mutilation in clinical and general population samples: prevalence, correlates, and functions |journal=Am J Orthopsychiatry |volume=68 |issue=4 |pages=609–20 |date=October 1998 |pmid=9809120 |doi=10.1037/h0080369 |url=}}</ref><ref name="pmid6887199">{{cite journal |vauthors=Archer S, Zayed AH, Rej R, Rugino TA |title=Analogues of hycanthone and lucanthone as antitumor agents |journal=J Med Chem |volume=26 |issue=9 |pages=1240–6 |date=September 1983 |pmid=6887199 |doi=10.1021/jm00363a007 |url=}}</ref><ref name="pmid9809120">{{cite journal |vauthors=Briere J, Gil E |title=Self-mutilation in clinical and general population samples: prevalence, correlates, and functions |journal=Am J Orthopsychiatry |volume=68 |issue=4 |pages=609–20 |date=October 1998 |pmid=9809120 |doi=10.1037/h0080369 |url=}}</ref><ref name="pmid17178643">{{cite journal |vauthors=Muehlenkamp JJ, Gutierrez PM |title=Risk for suicide attempts among adolescents who engage in non-suicidal self-injury |journal=Arch Suicide Res |volume=11 |issue=1 |pages=69–82 |date=2007 |pmid=17178643 |doi=10.1080/13811110600992902 |url=}}</ref><ref name="pmid22435988">{{cite journal |vauthors=Sornberger MJ, Heath NL, Toste JR, McLouth R |title=Nonsuicidal self-injury and gender: patterns of prevalence, methods, and locations among adolescents |journal=Suicide Life Threat Behav |volume=42 |issue=3 |pages=266–78 |date=June 2012 |pmid=22435988 |doi=10.1111/j.1943-278X.2012.0088.x |url=}}</ref><ref name="pmid22880967">{{cite journal |vauthors=Kuentzel JG, Arble E, Boutros N, Chugani D, Barnett D |title=Nonsuicidal self-injury in an ethnically diverse college sample |journal=Am J Orthopsychiatry |volume=82 |issue=3 |pages=291–7 |date=July 2012 |pmid=22880967 |doi=10.1111/j.1939-0025.2012.01167.x |url=}}</ref><ref name="pmid26114574">{{cite journal |vauthors=Wan Y, Chen J, Sun Y, Tao F |title=Impact of Childhood Abuse on the Risk of Non-Suicidal Self-Injury in Mainland Chinese Adolescents |journal=PLoS One |volume=10 |issue=6 |pages=e0131239 |date=2015 |pmid=26114574 |pmc=4482708 |doi=10.1371/journal.pone.0131239 |url=}}</ref>
*The beginning of NSSI is most common in early adolescence, between the ages of 12 and 14, however NSSI behavior has also been seen in [[children]] under the age of 12.
*The beginning of NSSI is most common in early [[adolescence]], between the ages of 12 and 14, however NSSI [[behavior]] has also been seen in [[children]] under the age of 12.
*Self-cutting is the most prevalent method, followed by burning, head banging, hitting, and sctratching. Most people who engage in NSSI, use a combination of methods to [[affect]] their [[wrist]]s, [[arm]]s, [[stomach]] and [[leg]]s.
*Self-cutting is the most prevalent method, followed by burning, head banging, hitting, and sctratching. Most people who engage in NSSI, use a combination of methods to [[affect]] their [[wrist]]s, [[arm]]s, [[stomach]] and [[leg]]s.
*The findings of several [[research]] studies showed that [[women]] exhibited more NSSI behaviors than [[men]].
*The findings of several [[research]] studies showed that [[women]] exhibited more NSSI behaviors than [[men]].
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*Inserted objects under the [[nails]] or [[skin]]
*Inserted objects under the [[nails]] or [[skin]]
==Natural History, Complications, and Prognosis==
<br />
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
==Diagnosis==
==Diagnosis==
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*[[Urinalysis]]
*[[Urinalysis]]
*[[Human chorionic gonadotropin]] ([[pregnancy]]) in girls
*[[Human chorionic gonadotropin]] ([[pregnancy]]) in girls
===Electrocardiogram===
There are no ECG findings associated with [disease name].
OR
An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
===X-ray===
There are no x-ray findings associated with [disease name].
OR
An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
===Echocardiography or Ultrasound===
There are no echocardiography/ultrasound findings associated with [disease name].
OR
Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
===CT scan===
There are no CT scan findings associated with [disease name].
OR
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
===MRI===
===MRI===
Resting state fMRI (rsfMRI or R-fMRI) is a method of functional magnetic resonance imaging (fMRI). When fMRI was done on a patient with NSSI, the findings were:<ref name="pmid28628767">{{cite journal |vauthors=Westlund Schreiner M, Klimes-Dougan B, Mueller BA, Eberly LE, Reigstad KM, Carstedt PA, Thomas KM, Hunt RH, Lim KO, Cullen KR |title=Multi-modal neuroimaging of adolescents with non-suicidal self-injury: Amygdala functional connectivity |journal=J Affect Disord |volume=221 |issue= |pages=47–55 |date=October 2017 |pmid=28628767 |pmc=5555154 |doi=10.1016/j.jad.2017.06.004 |url=}}</ref>
[[File:FMRI in Non suicidal self injury.png|alt=Non suicidal self injury|thumb|322x322px|fMRI in Non suicidal self injury]]
Resting state [[fMRI]] (rsfMRI or R-fMRI) is a method of [[functional magnetic resonance imaging]] (fMRI). When fMRI was done on a patient with NSSI, the findings were:<ref name="pmid28628767">{{cite journal |vauthors=Westlund Schreiner M, Klimes-Dougan B, Mueller BA, Eberly LE, Reigstad KM, Carstedt PA, Thomas KM, Hunt RH, Lim KO, Cullen KR |title=Multi-modal neuroimaging of adolescents with non-suicidal self-injury: Amygdala functional connectivity |journal=J Affect Disord |volume=221 |issue= |pages=47–55 |date=October 2017 |pmid=28628767 |pmc=5555154 |doi=10.1016/j.jad.2017.06.004 |url=}}</ref>
* atypical amygdala-frontal connectivity
*atypical [[amygdala]]-[[frontal]] connectivity
* greater amygdala RSFC in dorsal anterior cingulate and supplementary motor area (SMA)
*greater [[amygdala]] RSFC in [[dorsal]] [[anterior cingulate]] and [[supplementary motor area]] (SMA)
There are no other imaging findings associated with [disease name].
OR
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
===Other Diagnostic Studies===
There are no other diagnostic studies associated with [disease name].
OR
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
==Treatment==
==Treatment==
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{| class="wikitable"
{| class="wikitable"
|+[[Psychotherapy]] for Non[[suicidal]] Self-Injury.
|+[[Psychotherapy]] for Non[[suicidal]] Self-Injury.
For 6 kinds of [[psychotherapy]] [[empirical]] [[evidence]] was available:
|-
|-
!Type of Psychotherapy!!Description
!Type of Psychotherapy!!Description
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|}
|}
[[Pharmacotherapy]] for Nonsuicidal Self-Injury:
*[[Pharmacotherapy]] for Nonsuicidal Self-Injury: There are 5 classes of drugs which are effective for NSSI [[treatment]]:
There are 5 classes of drugs which are effective for NSSI [[treatment]]:
**[[SSRI]]s (for example, fluoxetine)
[[SSRI]]s (for example, fluoxetine)
**[[Atypical antipsychotics]]
[[Atypical antipsychotics]]
**[[SNRI]]s (venlafaxine),
[[SNRI]]s (venlafaxine),
**[[Opioids]] (buprenorphine), and
[[Opioids]] (buprenorphine), and
**[[Opioid]] [[antagonist]]s (naltrexone).
[[Opioid]] [[antagonist]]s (naltrexone).
[[Treatment]] of adults with [[BPD]] with [[SSRI]], demonstrated abstinence from NSSI during the [[treatment]] and the 18-month follow up period. [[Atypical antipsychotics]] (such as [[aripiprazole]] and [[ziprasidone]]) resulted in [[reduction]] in [[rates]] and [[frequency]] of NSSI among self-injuring teenagers.
*[[Treatment]] of adults with [[BPD]] with [[SSRI]], demonstrated abstinence from NSSI during the [[treatment]] and the 18-month follow up period. [[Atypical antipsychotics]] (such as [[aripiprazole]] and [[ziprasidone]]) resulted in [[reduction]] in [[rates]] and [[frequency]] of NSSI among self-injuring teenagers.
Nonantipsychotics [[treatment]] in [[adult]]s with [[BPD]] resulted in decrease in the [[rates]] and [[frequency]] of NSSI significantly compared with the baseline. There has been reported benefits of [[fluoxetine]], [[venlafaxine]], [[naltrexone]] and [[buprenorphine]] in increasing the [[rates]] of NSSI abstinence and (or) in reducing NSSI frequency.
Combination [[Treatment]]s for Non[[suicidal]] Self-Injury
*Nonantipsychotics [[treatment]] in [[adult]]s with [[BPD]] resulted in decrease in the [[rates]] and [[frequency]] of NSSI significantly compared with the baseline. There has been reported benefits of [[fluoxetine]], [[venlafaxine]], [[naltrexone]] and [[buprenorphine]] in increasing the [[rates]] of NSSI abstinence and (or) in reducing NSSI frequency.
There has been a reporting of benefits of combing [[CBT]] and [[antidepressants]] together in the [[treatment]] of [[major depressive disorder]] in [[adolescent]]s
Comprehensive [[Therapeutic]] Programs for Nonsuicidal Self-Injury
*Combination [[Treatment]]s for Non[[suicidal]] Self-Injury
The effectiveness of comprehensive [[treatment]] programs for people with [[BPD]] or mixed [[personality disorder]]s can be seen as a significant decreases in NSSI rates after intervention. These customized programs comprised [[pharmacotherapy]], [[psychoeducation]], group and individual therapy incorporated with DBT skills training as part of [[treatment]].
**There has been a reporting of benefits of combing [[CBT]] and [[antidepressants]] together in the [[treatment]] of [[major depressive disorder]] in [[adolescent]]s
Other [[Interventions]] for Non[[suicidal]] Self-Injury
*Comprehensive [[Therapeutic]] Programs for Nonsuicidal Self-Injury
Following purposeful self-[[poisoning]], a structured postcard intervention dramatically decreased [[suicide]]-related consequences.
**The effectiveness of comprehensive [[treatment]] programs for people with [[BPD]] or mixed [[personality disorder]]s can be seen as a significant decreases in NSSI rates after intervention. These customized programs comprised [[pharmacotherapy]], [[psychoeducation]], group and individual therapy incorporated with DBT skills training as part of [[treatment]].
[[Patients]] attending assertiveness [[training]] classes biweekly led by a [[psychiatrist]] improved their [[self-acceptance]] and capacity to calmly communicate their needs and desires.
*Other [[Interventions]] for Non[[suicidal]] Self-Injury
Auricular [[acupuncture]] was linked to a substantial [[reduction]] in the [[incidence]] of NSSI in [[depressed]] adolescents.
**[[Patients]] attending assertiveness [[training]] classes biweekly led by a [[psychiatrist]] improved their [[self-acceptance]] and capacity to calmly communicate their needs and desires.
**Auricular [[acupuncture]] was linked to a substantial [[reduction]] in the [[incidence]] of NSSI in [[depressed]] adolescents.
Non-suicidalSelf Injury means the intentional or conscious effort by someone to destruct his or her own body tissues with out having any intent for suicidality. The most common examples associated with NSSI includes cutting, scratching, burning, banging, self hitting. Mostly the people who self injure themselves are having the history of using two or more methods out of what described before. Because NSSI is frequently connected with emotional and psychiatric discomfort, as well as an increased risk of suicide, correct establishment of conceptual and clinical models of this behavior are critical.
The Non suicidalSelf Injury is most commonly seen in young adults and adolescents age groups of around 13-14 years with a lifetime rates of 15-20%. But when the stats studied adultpopulation the rate is 6%. Psychiatric groups, particularly those who report features linked with emotionaldistress, such as negative emotionality, depression, anxiety, and emotion dysregulation, have the highest incidence of NSSI in both adolescents and adultage group. In addition People who are prone to self-directed negative emotions and self-criticism are more likely to develop NSSI. Although it is typical for people to believe that NSSI is more common in women, general population surveys show that men and women have similar rates. However the sex difference makes the contribution when its comes to the point of methods used for NSSI. The women's are more found to be using cutting whereas the men's more often use the method of hitting and burning.
Historical Perspective
In early 1844 Bethlem Royal Hospital asylum made clear distinction between "self injury or disposition to suicide"[1][2][3]
In 20th century, Karl Menninger was the first to decribe self harm as a clinical entity.
In 1871, G. Fielding Blandford, MD, differentiated between, "will harm or mutilate portion of their bodies" and those who "attempt in every manner to put an end to themselves". He defined self mutilations as nail biting, face or hand picking, and hair plucking are common in nervous people.
In 1896, George Gould and Walter Pyle, divided self mutilation cases into those committed:
In 1878, Walter Channing, published a case report of Helen Miller, who was possessed with urges to cut. She resided in an asylum and cut repetitively for 3 years.[4]
Classification
Non Suicidal Self Injury
The Non SuicidalSelf Injury also known as Self-harm, Self Injury, Self-inflicted violence, Self Injurious Behavior. [5] These are the common term used interchangeably by various authors and practioners to name the disease. The behavior entails intentionaltissueinjury that is usually carried out without a suicidal motive. Cutting the skin with a sharp item, such as a knife or razor blade, is the most prevalent type of self-harm. The word "self-mutilation" is also occasionally used, albeit it has connotations that some people find alarming, inaccurate, or unpleasant.
NSSI has been proposed as a disorder in the DSM-5's "Conditions for Further Study" category. It should be noted that this proposed diagnostic criteria for a futurediagnosis is not an officially approveddiagnosis and should not be utilized in clinical practice; rather, it is intended solely for research purposes. The NSSI is classified as deliberate self-inflicted harm without the intent to commit suicide. The criteria for diagnosing and identifying NSSI includes 5 or more days of self inflicted harm over the duration of one year without having any intention to commit the suicide and along with that the person must have been having a motivation to relief from the negative state or to achieve a positive state.
Self-harm is commonly misunderstood as an attention-seeking behavior; however, this is not always the case. Many self-harmers are self-conscious about their scars and wounds, and they feel bad about their actions, therefore they go to great measures to hide their actions from others. They try to give the alternate reasoning for their scars or try to hide them with clothing. Self-harmers aren't usually trying to take their own lives; instead, it's thought that they're using it as a coping method to ease emotional anguish or discomfort, or as a way to communicate their distress.
Self-injuring adolescents exhibit higher physiologicalresponse to stress (e.g., skin conductance) than non self-injuring adolescents. Over time this stress response stays same and sometimes it even increases.
Many persons who self-harm claim that it permits them to "get away" or "dissociate," removing their minds from painfulsensations. This can be accomplished by convincing the mind that the current suffering is due to the self-harm rather than the difficulties they were dealing with previously: the physicalpain serves as a diversion from the initial mental agony.To add to this notion, one can think how important it is to "stop" feelingemotional anguish and mental irritation. "A person may be hypersensitive and overloaded, with a plethora of thoughts whirling about in their heads, and they may get triggered or may decide to stop the overpowering sensations."
Alternatively, self-harm, on the other hand, might be a way of feeling something, even if it's unpleasant and painful. Anhedonia is a sense of emptiness or numbness experienced by those who self-harm, and physicalpain may provide relief from these feelings. "A person might be aloof from oneself, aloof from life, numb and unfeeling."They develop a desire to feel something, and try to create a sesation and "wake up".
Obsessions which are repetitive and persistent urges, thoughts or images followed by compulsions which are repetitive behaviors or mental acts that the individual feels driven to perform.
Unable to stop impulses which leads to physical and verbal aggression. These are out of proportion to the provocation, unplanned and cause subjective and psychosocial distress.
Use of tobacco, alcohol, and/or legal and illegal drugs causes disability, health problems,or failure to meet major responsibilities at work, school or home. Leads to problems with social interactions, impaired control, and risky behaviors.
The existence of two or more distinctpersonality states, as well as repeated gaps in recollection of personal information or experiences, characterizes identity disruption.
Epidemiology and Demographics
The prevalence of NSSI varies between 7.5 and 46.5 percent in teenagers, rising to 38.9 percent among students and 4–23% among adults. Despite the fact that self-injurious behaviour is a common occurrence, results from different studies differ significantly.[8][20][8][21][22][23][24]
The beginning of NSSI is most common in early adolescence, between the ages of 12 and 14, however NSSI behavior has also been seen in children under the age of 12.
Self-cutting is the most prevalent method, followed by burning, head banging, hitting, and sctratching. Most people who engage in NSSI, use a combination of methods to affect their wrists, arms, stomach and legs.
The findings of several research studies showed that women exhibited more NSSI behaviors than men.
Self-cutting is the most prevalent way among women, who are more prone than males to participate in NSSI methods that typically entail blood, whereas burning, hitting and banging are the most common means among men. Among college students, adolescents and adults equal incidence of NSSI has been reported.
Multiracial college students have the highest incidence rates in the ethnically varied sample, followed by Caucasian (16.8), and Hispanic (17%). Prevalence rates in Chinese students for NSSI is in the range of 24.9-29.2%. In the Turkish adolescent group it is 21.4%.
Risk Factors
The common risk factors involved in Non Suicidal Self Injury are as follows:[25][17]
Most of the people who show self-harming behaviour meet the DSM-5 criteria for Non Suicidal Self Injury.
DSM-5 Criteria for diagnosis of Non Suicidal Self Injury
History and Symptoms
Eighty percent of self-injury includes stabbing or cutting the skin with a sharp tool, sometimes completely piercing the skin. Self-harm is frequently committed in regions of the body that are readily hidden and undetectable to others. Most often it is a symptom of an underlying disorder and these people look for help to get out of this.
Common signs and symptoms that a person may be engaging in self-harm include the following:[29][30]
It's a combination of individual and group therapy, as well as a therapistconsultation team. DBT causes larger decreases in NSSI and SSI, which last for 6 to 12 months following therapy. DBT lowers the frequency, rate, and desire to participate in NSSI.
Emotion Regulation Group Therapy (ERGT)
ERGT is a 14-week group therapy program that focuses on developing emotion control and acceptance skills, as well as identifying and pursuing significant objectives and values. In comparison to treatment as usual (TAU) , there were considerably larger decreases in NSSI frequency. Studies involving a follow up period indicated that therapy effects are long-lasting.
MACT is a systematic, problem-solving treatment that includes individual counseling and bibliotherapy and is generally completed in six sessions. MACT has a substantial benefit over TAU (treatment as usaul) in lowering the frequency of NSSI in femaleadults with BPD.
VMT is an and expressive arts therapy that integrates sound-making, expressive writing, singing, movement, massage, and drama activities to minimize emotion dysregulation and enhance self-awareness. When compared to the 10-week pretreatment period, young females engaged in less frequent NSSI while receiving 10 weeks of VMT.
Pharmacotherapy for Nonsuicidal Self-Injury: There are 5 classes of drugs which are effective for NSSI treatment:
Comprehensive Therapeutic Programs for Nonsuicidal Self-Injury
The effectiveness of comprehensive treatment programs for people with BPD or mixed personality disorders can be seen as a significant decreases in NSSI rates after intervention. These customized programs comprised pharmacotherapy, psychoeducation, group and individual therapy incorporated with DBT skills training as part of treatment.
↑Ballard E, Bosk A, Pao M (April 2010). "Invited commentary: understanding brain mechanisms of pain processing in adolescents' non-suicidal self-injury". J Youth Adolesc. 39 (4): 327–34. doi:10.1007/s10964-009-9457-1. PMID19830534.
↑Bohus M, Limberger M, Ebner U, Glocker FX, Schwarz B, Wernz M, Lieb K (September 2000). "Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behavior". Psychiatry Res. 95 (3): 251–60. doi:10.1016/s0165-1781(00)00179-7. PMID10974364.
↑ 8.08.18.2Briere J, Gil E (October 1998). "Self-mutilation in clinical and general population samples: prevalence, correlates, and functions". Am J Orthopsychiatry. 68 (4): 609–20. doi:10.1037/h0080369. PMID9809120.
↑Deliberto TL, Nock MK (2008). "An exploratory study of correlates, onset, and offset of non-suicidal self-injury". Arch Suicide Res. 12 (3): 219–31. doi:10.1080/13811110802101096. PMID18576203.
↑Eisenberger NI, Jarcho JM, Lieberman MD, Naliboff BD (December 2006). "An experimental study of shared sensitivity to physical pain and social rejection". Pain. 126 (1–3): 132–8. doi:10.1016/j.pain.2006.06.024. PMID16890354.
↑Eisenberger NI, Lieberman MD (July 2004). "Why rejection hurts: a common neural alarm system for physical and social pain". Trends Cogn Sci. 8 (7): 294–300. doi:10.1016/j.tics.2004.05.010. PMID15242688.
↑Joyce PR, Light KJ, Rowe SL, Cloninger CR, Kennedy MA (March 2010). "Self-mutilation and suicide attempts: relationships to bipolar disorder, borderline personality disorder, temperament and character". Aust N Z J Psychiatry. 44 (3): 250–7. doi:10.3109/00048670903487159. PMID20180727.
↑Rossow I, Hawton K, Ystgaard M (2009). "Cannabis use and deliberate self-harm in adolescence: a comparative analysis of associations in England and Norway". Arch Suicide Res. 13 (4): 340–8. doi:10.1080/13811110903266475. PMID19813111.
↑Urnes O (April 2009). "[Self-harm and personality disorders]". Tidsskr Nor Laegeforen (in Norwegian). 129 (9): 872–6. doi:10.4045/tidsskr.08.0140. PMID19415088.CS1 maint: Unrecognized language (link)
↑Humphries SR (March 1988). "Munchausen syndrome. Motives and the relation to deliberate self-harm". Br J Psychiatry. 152: 416–7. doi:10.1192/bjp.152.3.416. PMID3167380.
↑Johnson CP, Myers SM (November 2007). "Identification and evaluation of children with autism spectrum disorders". Pediatrics. 120 (5): 1183–215. doi:10.1542/peds.2007-2361. PMID17967920.
↑Foa EB, Kozak MJ, Goodman WK, Hollander E, Jenike MA, Rasmussen SA (January 1995). "DSM-IV field trial: obsessive-compulsive disorder". Am J Psychiatry. 152 (1): 90–6. doi:10.1176/ajp.152.1.90. PMID7802127.
↑Archer S, Zayed AH, Rej R, Rugino TA (September 1983). "Analogues of hycanthone and lucanthone as antitumor agents". J Med Chem. 26 (9): 1240–6. doi:10.1021/jm00363a007. PMID6887199.
↑Muehlenkamp JJ, Gutierrez PM (2007). "Risk for suicide attempts among adolescents who engage in non-suicidal self-injury". Arch Suicide Res. 11 (1): 69–82. doi:10.1080/13811110600992902. PMID17178643.
↑Sornberger MJ, Heath NL, Toste JR, McLouth R (June 2012). "Nonsuicidal self-injury and gender: patterns of prevalence, methods, and locations among adolescents". Suicide Life Threat Behav. 42 (3): 266–78. doi:10.1111/j.1943-278X.2012.0088.x. PMID22435988.
↑Kuentzel JG, Arble E, Boutros N, Chugani D, Barnett D (July 2012). "Nonsuicidal self-injury in an ethnically diverse college sample". Am J Orthopsychiatry. 82 (3): 291–7. doi:10.1111/j.1939-0025.2012.01167.x. PMID22880967.
↑Calvete E, Orue I, Aizpuru L, Brotherton H (2015). "Prevalence and functions of non-suicidal self-injury in Spanish adolescents". Psicothema. 27 (3): 223–8. doi:10.7334/psicothema2014.262. PMID26260928.
↑Leong CH, Wu AM, Poon MM (2014). "Measurement of perceived functions of non-suicidal self-injury for Chinese adolescents". Arch Suicide Res. 18 (2): 193–212. doi:10.1080/13811118.2013.824828. PMID24568552.
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