Non-suicidal self-injury
Non-suicidal self-injury
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DOI：
10.1007/s00787-010-0156-y
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发表时间：
2011-02-01
影响因子：
6.4
通讯作者：
Goodyer, Ian
中科院分区：
文献类型：
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作者：
Wilkinson, Paul;Goodyer, Ian
自伤是青春期比较常见的现象。通常没有自杀意图;相反，该行为是出于一个或多个原因，与减少痛苦的影响，施加自我惩罚和/或向重要的其他人发出个人痛苦的信号有关。非自杀性自伤（NSSI）是故意的，不包含死亡的愿望，因此病因可能至少部分不同于自杀行为本身。有趣的是，NSSI与随后的自杀企图有关，这表明这些行为及其相关心理可能处于相同的风险轨迹上。NSSI既没有出现在DSM-IV或ICD 10中作为一种疾病，也不构成任何当前焦虑或抑郁综合征的组成部分。这种缺乏疾病分类学的认识加上明确的精神病理学重要性将在第5版精神障碍诊断和统计手册（DSM-5）中得到承认，NSSI被归类为一种综合征。我们同意这是适当的，可能会产生一些积极的后果，包括：（1）改善专业人员和患者之间的沟通;（2）为治疗和管理决策提供信息;（3）增加对NSSI性质，过程和结果的研究。我们同意拟议的DSM-5诊断标准，虽然认为损害标准将更好地措辞，如果它说，自我伤害是相关的，而不是因果关系，强烈的痛苦。
Self-injury is a relatively common phenomenon in adolescence. Often there is no suicidal intent; rather, the action is used for one or more reasons that relate to reducing distressing affect, inflicting self-punishment and/or signalling personal distress to important others. Non-suicidal self-injury (NSSI) is both deliberate and contains no desire to die and therefore aetiology is likely to be at least partly different to suicidal behaviour per se. Interestingly, NSSI is associated with subsequent suicide attempts suggesting that these behaviours and their related psychology may lie on the same risk trajectory. NSSI neither appears in DSM-IV or ICD 10 as a disorder nor does it constitute a component of any current anxious or depressive syndrome. This lack of nosological recognition coupled with clear psychopathological importance is to be recognised in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), with NSSI being classified as a syndrome in its own right. We agree that this is appropriate and is likely to have several positive consequences including: (1) improving communication between professionals and patients; (2) informing treatment and management decisions; (3) increasing research into the nature, course and outcome of NSSI. We agree with the proposed DSM-5 diagnostic criteria, although believe the impairment criterion would be better phrased if it stated that self-injury is associated with, rather than causal for, intense distress.