Nonsuicidal Self-Injury and the Relationship to Suicide (pp. 131-140)
Authors: (Stephanie Stockburger, Division of Adolescent Medicine and Young Parent programs, Kentucky Clinic, Department of Pediatrics, Kentucky Childrenís Hospital, University of Kentucky College of Medicine, Lexington, Kentucky, United States of America)
Abstract: Nonsuicidal self-injury (NSSI) is the deliberate, direct, and self-inflicted destruction of
body tissue resulting in immediate tissue damage done for purposes not socially
sanctioned. Common forms of NSSI include cutting, carving words, burning, scratching,
or hitting oneself to the point of injury. In the United States, studies have found that the
lifetime prevalence of NSSI ranges from 12% to 37.2% in the middle school populations
and 12% to 20% in late adolescent and young adult populations. Risk factors for NSSI
include depression, anxiety, perceived isolation, low family warmth, poor family
communication, abuse, and hopelessness. Individuals who self-harm are at increased risk
of suicide although NSSI is considered a coping mechanism to avert suicide. There are
several theories as to why NSSI carries increased risk of suicide although more research
is needed to truly determine the association. Psychiatric disorders including depression,
anxiety, substance misuse, and personality disorders are relatively common among
individuals who self-harm. Currently, treatment for NSSI consists of psychotherapy and
possibly medication although no formal guidelines are in place. Areas for future research
about NSSI include the relationship between NSSI and suicide as well as treatment for
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