By:
Lourie
W. Reichemberg
Nonsuicidal self-injury is a maladaptive coping strategy that is frequently used to reduce emotional pain. NSSI is often, but not always, related to an increased risk of suicide.
In DSM-IV-TR,
self-injury was listed as a symptom of borderline personality
disorder, which was the only category in which cutting or other self-harming
behaviors appeared. Given a 12% to 23% prevalence rate of NSSI among nonclinical
adolescent populations, clearly many teens who do not meet the criteria
for borderline personality disorder are also in need of help, and some are at increased risk of accidental death from NSSI or as a result of later suicide
attempts (Plener & Fegert, 2012; Washburn et al., 2012).
Longitudinal studies have found a decline in rates of NSSI in
adulthood, resulting in a larger focus on adolescents to help curb this very
dangerous yet highly treatable condition. Rates of NSSI appear to
increase following media exposure and exposure to self-injurious practices
shared on the Internet. Therefore, clinicians are advised to assess their
adolescent clients’ online behavior (Washburn et al., 2012). Although no treatment
has been designed specifically for use with the high-risk adolescent
population, current research is available about successful treatment for NSSI.
Therapeutic approaches to treating NSSI are similar to those
used to treat self-harming behaviors in people with borderline
personality disorder. Specifically, dialectical behavior therapy,
schema-focused CBT, and mentalizationbased treatment (MBT) modalities have been
found to decrease suicidality and nonsuicidal self-harming behaviors.
Physical activity and participation in
organized sports have
been found to be protective against NSSI behaviors in adolescence. Because of the
alarming increase in the incidence of NSSI, research is currently underway
to explore the effect of short-term problemsolving behavior and transdiagnostic
treatment approaches. Seligman and Reichenberg (2012, pp. 374–377) provide a more
in-depth discussion of treatment modalities for this important disorder, which
can sometimes have lethal outcomes. Including NSSI
in Section III of DSM-5 sends
a strong message that more research is needed.
References
Lourie W. Reichemberg,
DSM-5™ Essentials The Savvy Clinician’s Guide to the Changes in Criteria, 2014
by John Wiley & Sons, Inc
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