Advances in Clinical and Experimental Medicine
2018, vol. 27, nr 2, February, p. 257–261
Publication type: review article
Non-suicidal self-injury (NSSI) and suicidal: Criteria differentiation
1 Department and Clinic of Psychiatry, Wroclaw Medical University, Poland
There are 2 types of basic self-destructive behavior: suicide and non-suicidal self-injury (NSSI). Currently, more and more researchers point out significant disorders which are NSSI behavior. This phenomenon is not new; NSSI seemingly has always been present in society, and certainly in approx. 10% of the population worldwide in recent times. Despite the enormous scale of the phenomenon, so far it has been overlooked and marginalized. They were considered transient behavior, typical of adolescence, a part of youthful rebellion. Current research indicates that the disorder affects the adult population in almost equal measure. It is only in the latest diagnostic classification – Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5) by American Psychiatric Association – that has considered NSSI a separate class of behavior. Up to now, it was classified as a prelude to suicide or an element of personality disorders. NSSI is more commonly associated with disturbing behavior and suicide attempts.
non-suicidal self-injury, suicide, suicide attempt
- Putowski M, Piróg M, Podgórniak M, Zawiślak J, Piecewicz-Szczęsna H. Analiza epidemiologiczna występowania samobójstw w Polsce w latach 2000-2013. Probl Hig Epidemiol. 2015;96(1):264-268.
- Gratz KL, Conrad SD, Roemer L. Risk factors for deliberate self-harm among college students. Am J Orthopsychiatry. 2002;72:128–140.
- American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
- Walsh B. Treating Self-Injury: A Practical Guide. New York, NY; Guilford Press; 2006.
- Shneidman E. Definition of Suicide. New York, NY: John Wiley & Sons; 1985:202–213.
- Whitlock J, Muehlenkamp JJ, Eckenrode J. Variation in non-suicidal self-injury: Identification and features of latent classes in a college population of emerging adults. J Clin Child Adolesc Psychol. 2008;37:725–735.
- Babiker G, Arnold L. Autoagresja, mowa zranionego ciała. Gdańsk: Gdańskie Wydawnictwo Psychologiczne; 2003.
- Walsh B, Rosen P. Self-Mutilation: Theory, Research and Treatment. New York, NY: Guilford Press; 1988.
- Conterio K, Lader W. Bodily Harm: The Breakthrough Healing Program for Self Injurers. New York, NY: Hyperion Press; 1998.
- Whitlock JL, Eckenrode J, Silverman D. Self-injurious behaviors in a college population. Pediatrics. 2006;117:1939–1948.
- Berman AL, Jobes DA, Silverman MM. Adolescent Suicide: Assessment and Intervention. 2nd ed. Washington, DC: American Psychological Association; 2006.
- Whitlock J, Muehlenkamp J, Eckenrode J, et al. Nonsuicidal self-injury as a gateway to suicide in adolescents and young adults. J Adolesc Health. 2013;52:486–492.
- Nock MK, Kessler RC. Prevalence of and risk factors for suicide attempts versus suicide gestures: Analysis of the National Comorbidity Survey. J Abnorm Psychol. 2006;115:616–623.
- Kubiak A. Mechanizm radzenia sobie z napięciem u osób podejmujących nawykowe samouszkodzenia. 2013. [Unpublished doctoral thesis.]
- Beck AT, Rush, AJ, Shaw BF, Emery G. Cognitive Therapy of Depression. New York, NY: Guilford Press; 1979.
- Seligman MEP. Helplessness: On Depression, Development, and Death. San Francisco, CA: W.H. Freeman; 1975. (Paperback reprint edition, W.H. Freeman; 1992.)
- Milnes D, Owens D, Blenkiron P. Problems reported by self-harm patients: Perception, hopelessness and suicidal intent. J Psychosom Res. 2002;53:819–822.
- Muehlenkamp J, Gutierrez PM. Risk for suicide attempts among adolescents who engage in non-suicidal self-injury. Arch Suicide Res. 2007;11:69–82.
- Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. J Psychiatry. 2007; Mar;170:205-28.
- Rosa K. Młodzież podejmująca próby samobójcze. Charakterystyka socjologiczna. Przegl Lek. 2007;1:24–30.
- McGirr A, Renaud J, Bureau A, Seguin M, Lesage A, Turecki G. Impulsive-aggressive behaviors and completed suicide across the life cycle: A predisposition for younger age of suicide. Psychol Med. 2006;38(3):407–417
- Radomsky ED, Gretchen JJ, Mann, Sweeney JA. Suicidal behavior in patients with schizophrenia and other psychotic disorders. Am J Psychiatry. 1999;156:1590–1595.
- Sareen J, Afifi TO, McMillan KA, Asmundson GJ. Relationship between household income and mental disorders: Findings from a population-based longitudinal study. Arch Gen Psychiatry. 2011;68(4):419–427.
- Bostwick JM, Pankratz SV. Affective disorders and suicide risk: A reexamination. Am J Psychiatry. 2000;157:1925–1932.
- Kerr PL, Muehlenkamp JJ, Turner JM. Nonsuicidal self-injury: A review of current research for family medicine and primary care physicians. JABFM. 2010;23(2):240–259.
- Yates, TM. The developmental psychopathology of self-injurious behavior: Compensatory regulation in posttraumatic adaptation. Clin Psychol Rev. 2004;24(1):35–74.
- Maltsberger JT. Suicide Risk. The Formulation of Clinical Judgment. New York, NY: University Press; 2013.
- Cooper J, Biddle L, Owen-Smith A, et al. Suicide after deliberate self-harm: A 4-year cohort study. Am J Psychiatry. 2006;162(2):297–230.
- Ross S, Heath NL. A study of the frequency of self-mutilation in a community sample of adolescents. J Youth Adolescence. 2002;31:67–77.
- Whitlock J, Knox KL. The relationship between self-injurious behavior and suicide in a young adult population. Arch Pediatr Adolesc Med. 2007;161:634–640.
- Nock M, Prinstein MA. Functional approach to the assessment of self-mutilative behavior. J Consult Clin Psychology. 2004;2(5):885–890.