self injurious behavior


Summary: Behavior in which persons hurt or harm themselves without the motive of suicide or of sexual deviation.

Top Publications

  1. Sansone R, Songer D, Sellbom M. The relationship between suicide attempts and low-lethal self-harm behavior among psychiatric inpatients. J Psychiatr Pract. 2006;12:148-52 pubmed
    ..g., torturing oneself with self-defeating thoughts, abusing prescription medications). These data suggest that suicide attempts and low-lethal self-harm behavior are likely to co-exist in many psychiatric inpatients. ..
  2. Nixon M, Cloutier P, Jansson S. Nonsuicidal self-harm in youth: a population-based survey. CMAJ. 2008;178:306-12 pubmed publisher
    ..Just over half of youth reported seeking help for nonsuicidal self-harm. Clinicians who encounter youth should be vigilant to assess for this behaviour in youth who present with mental health issues. ..
  3. Weierich M, Nock M. Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury. J Consult Clin Psychol. 2008;76:39-44 pubmed publisher
    ..Future research must test the temporal relation between childhood sexual abuse, PTSD symptoms, and NSSI and identify additional pathways to engagement in NSSI. ..
  4. Nock M, Joiner T, Gordon K, Lloyd Richardson E, Prinstein M. Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006;144:65-72 pubmed
  5. Rosychuk R, Huston C, Prasad N. Spatial event cluster detection using a compound Poisson distribution. Biometrics. 2006;62:465-70 pubmed
    ..Pediatric self-inflicted injuries requiring presentation to Alberta emergency departments provide an illustration. ..
  6. Young R, van Beinum M, Sweeting H, West P. Young people who self-harm. Br J Psychiatry. 2007;191:44-9 pubmed
    ..Current labour market position was a stronger predictor than parental social class or gender for self-harm, and was linked to level of severity, motivation for starting and ceasing, and service utilisation. ..
  7. Klonsky E, Muehlenkamp J. Self-injury: a research review for the practitioner. J Clin Psychol. 2007;63:1045-56 pubmed
    ..Psychotherapies that emphasize emotion regulation, functional assessment, and problem solving appear to be most effective in treating self-injury. ..
  8. Portzky G, De Wilde E, Van Heeringen K. Deliberate self-harm in young people: differences in prevalence and risk factors between the Netherlands and Belgium. Eur Child Adolesc Psychiatry. 2008;17:179-86 pubmed
    ..These results support the assumption that sociocultural aspects of nations can influence the risk of deliberate self-harm and are important to consider when developing prevention strategies. ..
  9. Brown S, Williams K, Collins A. Past and recent deliberate self-harm: emotion and coping strategy differences. J Clin Psychol. 2007;63:791-803 pubmed

More Information


  1. Jacobson C, Gould M. The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: a critical review of the literature. Arch Suicide Res. 2007;11:129-47 pubmed
  2. Hilt L, Cha C, Nolen Hoeksema S. Nonsuicidal self-injury in young adolescent girls: moderators of the distress-function relationship. J Consult Clin Psychol. 2008;76:63-71 pubmed publisher
    ..The clinical implications of these findings include designing preventions that address the particular contexts of self-injurious behavior. ..
  3. Patton G, Hemphill S, Beyers J, Bond L, Toumbourou J, McMorris B, et al. Pubertal stage and deliberate self-harm in adolescents. J Am Acad Child Adolesc Psychiatry. 2007;46:508-14 pubmed
    ..Puberty is associated with changes in the form and frequency of self-harm. For adolescents with a gap between puberty and brain development, risk factors such as early sexual activity and substance abuse may be particularly potent. ..
  4. Klonsky E, Olino T. Identifying clinically distinct subgroups of self-injurers among young adults: a latent class analysis. J Consult Clin Psychol. 2008;76:22-27 pubmed publisher
    ..A 4th class (11% of participants) cut themselves in private, in the service of automatic functions, and was characterized by high suicidality. Clinical and research implications are discussed. ..
  5. Whitlock J, Knox K. The relationship between self-injurious behavior and suicide in a young adult population. Arch Pediatr Adolesc Med. 2007;161:634-40 pubmed
    ..Since it is well established that SIB is not a suicidal gesture, many clinicians assume that suicide assessment is unnecessary. Our findings suggest that the presence of SIB should trigger suicide assessment. ..
  6. Armey M, Crowther J. A comparison of linear versus non-linear models of aversive self-awareness, dissociation, and non-suicidal self-injury among young adults. J Consult Clin Psychol. 2008;76:9-14 pubmed publisher
    ..These findings suggest novel approaches to prevention and treatment of NSSI as well. ..
  7. Muehlenkamp J, Gutierrez P. Risk for suicide attempts among adolescents who engage in non-suicidal self-injury. Arch Suicide Res. 2007;11:69-82 pubmed
    ..Clinical implications of the findings are discussed. ..
  8. Nock M, Holmberg E, Photos V, Michel B. Self-Injurious Thoughts and Behaviors Interview: development, reliability, and validity in an adolescent sample. Psychol Assess. 2007;19:309-17 pubmed
    ..The authors concluded that the SITBI uniformly and comprehensively assesses a wide range of self-injury-related constructs and provides a new instrument that can be administered with relative ease in both research and clinical settings. ..
  9. Skeem J, Silver E, Aippelbaum P, Tiemann J. Suicide-related behavior after psychiatric hospital discharge: Implications for risk assessment and management. Behav Sci Law. 2006;24:731-46 pubmed
    ..Instead, patients' rate of SRB was relatively constant over the one-year follow-up. Implications for risk assessment and management in acute inpatient settings are discussed. ..
  10. Nock M, Mendes W. Physiological arousal, distress tolerance, and social problem-solving deficits among adolescent self-injurers. J Consult Clin Psychol. 2008;76:28-38 pubmed publisher
    ..These findings highlight the importance of attending to increased arousal, distress tolerance, and problem-solving skills in the assessment and treatment of NSSI. ..
  11. Prinstein M. Introduction to the special section on suicide and nonsuicidal self-injury: a review of unique challenges and important directions for self-injury science. J Consult Clin Psychol. 2008;76:1-8 pubmed publisher
    ..Articles in this special section include studies of functional models of NSSI, studies that examine more distal risk factors for NSSI, and studies of suicidality. A brief review of current research in these areas is offered. ..
  12. Anderson M, Standen P. Attitudes towards suicide among nurses and doctors working with children and young people who self-harm. J Psychiatr Ment Health Nurs. 2007;14:470-7 pubmed
    ..It is argued that complex attitudes need to be taken into account in training for healthcare professionals and in the development of contemporary suicide prevention policy. ..
  13. Hawton K, Harriss L. Deliberate self-harm by under-15-year-olds: characteristics, trends and outcome. J Child Psychol Psychiatry. 2008;49:441-8 pubmed
    ..DSH in children and young adolescents is usually related to life problems, is generally of low suicidal intent, and is associated with a relatively low long-term risk of suicide. ..
  14. Fortune S, Sinclair J, Hawton K. Adolescents' views on preventing self-harm. A large community study. Soc Psychiatry Psychiatr Epidemiol. 2008;43:96-104 pubmed
    ..Enhancing the provision of school-based mental heath programmes and increased youth-orientation in helping services are indicated. ..
  15. Klonsky E. Non-suicidal self-injury: an introduction. J Clin Psychol. 2007;63:1039-43 pubmed
    ..The articles feature case illustrations and treatment recommendations, and all have direct implications for clinical practice. ..
  16. Lloyd Richardson E, Perrine N, Dierker L, Kelley M. Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychol Med. 2007;37:1183-92 pubmed
    ..Intervention efforts should be tailored to reducing individual issues that contribute to NSSI and building alternative skills for positive coping, communication, stress management, and strong social support. ..
  17. Prinstein M, Nock M, Simon V, Aikins J, Cheah C, Spirito A. Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization. J Consult Clin Psychol. 2008;76:92-103 pubmed publisher
    ..Findings underscore the need for more longitudinal research on the course of adolescent suicidality. ..
  18. Gratz K, Gunderson J. Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behav Ther. 2006;37:25-35 pubmed
    ..While these preliminary results are promising, the study's limitations require their replication in a larger-scale randomized controlled trial. ..
  19. Whitlock J, Eckenrode J, Silverman D. Self-injurious behaviors in a college population. Pediatrics. 2006;117:1939-48 pubmed
    ..The reticence of these clients to seek help or advice renders it critical that medical and mental health providers find effective strategies for detecting and addressing self-injurious behaviors. ..
  20. Yates T, Tracy A, Luthar S. Nonsuicidal self-injury among "privileged" youths: longitudinal and cross-sectional approaches to developmental process. J Consult Clin Psychol. 2008;76:52-62 pubmed publisher
  21. Lundh L, Karim J, Quilisch E. Deliberate self-harm in 15-year-old adolescents: a pilot study with a modified version of the Deliberate Self-Harm Inventory. Scand J Psychol. 2007;48:33-41 pubmed
    ..High rates of deliberate self-harm were associated with low self-esteem and low mindfulness. ..
  22. Linehan M, Comtois K, Brown M, Heard H, Wagner A. Suicide Attempt Self-Injury Interview (SASII): development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychol Assess. 2006;18:303-12 pubmed
    ..The SASII was found to have very good interrater reliability and adequate validity. ..
  23. Welch S, Linehan M, Sylvers P, Chittams J, Rizvi S. Emotional responses to self-injury imagery among adults with borderline personality disorder. J Consult Clin Psychol. 2008;76:45-51 pubmed publisher
    ..Support for the model was not found for SAs. Possible implications of patterns that demonstrate decreases in negative emotion during accidental death imagery are discussed. ..
  24. Danchin C, MacLeod A, Tata P. Painful engagement in deliberate self-harm: The role of conditional goal setting. Behav Res Ther. 2010;48:915-20 pubmed publisher
  25. Bentson K, Crockett C, Wahl K, Runeson E, Bellanca R, Lee G, et al. Floating limb behaviors and self-biting are associated in laboratory monkeys. Am J Primatol. 2010;72:725-33 pubmed publisher
    ..Continued research on factors associated with floating limb behaviors across demographic groups and settings may provide insights into the etiology and treatment of self-biting...
  26. Rahman N, Featherstone N, Decaluwe D. Spider-man, magnets, and urethral-cutaneous fistula. Urology. 2010;76:162-3 pubmed publisher
    ..This led to the development of a urethral-cutaneous fistula. To our knowledge, this is the first reported case illustrating the development of an iatrogenic fistula after self-insertion of a foreign body in the genitourinary tract. ..
  27. Lanes E. Identification of risk factors for self-injurious behavior in male prisoners. J Forensic Sci. 2009;54:692-8 pubmed publisher
    ..3%. False positive and false negative rates were 2.3% and 3.4%, respectively. Implications for the assessment of prisoners at risk for SIB as well as suggested future directions for SIB prisoner research are discussed. ..
  28. Baldwin S, Griffiths P. Do specialist community public health nurses assess risk factors for depression, suicide, and self-harm among South Asian mothers living in London?. Public Health Nurs. 2009;26:277-89 pubmed publisher
    ..While SCPHNs understood some aspects of South Asian culture, service improvements must be made to ensure better care provision. ..
  29. Truong H, Dudding T, Blanchard C, Elsea S. Frameshift mutation hotspot identified in Smith-Magenis syndrome: case report and review of literature. BMC Med Genet. 2010;11:142 pubmed publisher
    ..We expect that as more patients are sequenced for mutations in RAI1, the incidence of frameshift mutations in this hotspot will become more evident. ..
  30. Anselmi N, Mirigliani A. [Personality disorders self-inflicted woundings in detention]. Riv Psichiatr. 2010;45:58-60 pubmed
    ..Psychiatrists, psychologists and prison guards must consider this manipulative, recriminating, self-therapeutic behavioural way aimed just by obtaining benefits. ..
  31. Kernberg O. The concept of the death drive: a clinical perspective. Int J Psychoanal. 2009;90:1009-23 pubmed publisher
  32. Sansone R, Wiederman M, Schumacher D, Routsong Weichers L. The prevalence of self-harm behaviors among a sample of gastric surgery candidates. J Psychosom Res. 2008;65:441-4 pubmed publisher
    ..g., promiscuity and alcohol abuse), and (b) the anticipated prevalence rate for past suicide attempts in this population appears to be approximately 10%. ..
  33. Matsumoto T, Tsutsumi A, Izutsu T, Imamura F, Chiba Y, Takeshima T. Comparative study of the prevalence of suicidal behavior and sexual abuse history in delinquent and non-delinquent adolescents. Psychiatry Clin Neurosci. 2009;63:238-40 pubmed publisher
    ..Results showed that delinquent adolescents, particularly girls, more frequently reported histories of suicidal behavior and sexual abuse than non-delinquent adolescents. ..
  34. Banerjee S, Chowdhury A, Schelling E, Brahma A, Biswas M, Weiss M. Deliberate self-harm and suicide by pesticide ingestion in the Sundarban region, India. Trop Med Int Health. 2009;14:213-9 pubmed publisher
  35. Rezaeian M. Islam and suicide: a short personal communication. Omega (Westport). 2008;58:77-85 pubmed
    ..It also covers issues which may have an adverse effect on suicide within Islamic countries and consequently tries to sketch a path ahead in the area of suicide research within the Islamic countries. ..
  36. Thorson R, Matson J, Rojahn J, Dixon D. Behaviour problems in institutionalised people with intellectual disability and schizophrenia spectrum disorders. J Intellect Dev Disabil. 2008;33:316-22 pubmed publisher
    ..The SSD group was unique compared to the other two groups, particularly for severity of stereotyped behaviours. Many specific behavioural differences were also related to either SSD or general psychopathology. ..
  37. Gilbert P, McEwan K, Bellew R, Mills A, Gale C. The dark side of competition: How competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self-harm. Psychol Psychother. 2009;82:123-36 pubmed publisher
    ..This may increase vulnerability to depression, anxiety and stress. ..
  38. De Leo D, Dudley M, Aebersold C, Mendoza J, Barnes M, Harrison J, et al. Achieving standardised reporting of suicide in Australia: rationale and program for change. Med J Aust. 2010;192:452-6 pubmed
    ..A systemic coordinated program should address current inaccuracies, and social stigma about suicide and self-harm must be tackled if widespread underreporting is to stop. ..
  39. Singh R, Dalal S. Self-inflicted macro urethro-cutaneous fistula. Asian J Surg. 2009;32:177-9 pubmed
  40. Schrom T, Amm S. [Unusual case of oesophageal foreign body as part of a self-harm syndrome]. Laryngorhinootologie. 2009;88:253-6 pubmed publisher
    ..Particularly in cases of unusual foreign objects or repeated foreign object ingestion, it should be considered whether a psychological illness could be the cause and whether the introduction of appropriate therapy could be expedient. ..
  41. Ahmadi A, Mohammadi R, Schwebel D, Yeganeh N, Hassanzadeh M, Bazargan Hejazi S. Psychiatric disorders (Axis I and Axis II) and self-immolation: a case-control study from Iran. J Forensic Sci. 2010;55:447-50 pubmed publisher
    ..As a result, it has been suggested that increasing education about problem-solving approaches, and coping skills for females and at-risk groups are appropriate prevention programs and strategies in Iranian communities. ..
  42. Plener P, Brunner R, Resch F, Fegert J, Libal G. [Nonsuicidal self-injury in adolescence]. Z Kinder Jugendpsychiatr Psychother. 2010;38:77-88; quiz 88-9 pubmed publisher
    ..There is little evidence for psychopharmacological interventions in childhood and adolescence; thus treatment should focus on psychotherapeutic interventions. ..
  43. Razavi H, Price N. Self-inflicted penetrating eye injuries using a razor blade: case report. BMC Ophthalmol. 2009;9:14 pubmed publisher
    ..Self-inflicted ocular injury may be possible in non-psychotic patients, as a situational response to a life event. Urgent repair can completely restore vision in some cases. Referral for psychiatric counseling is mandatory. ..
  44. Heyerdahl F, Bjornaas M, Dahl R, Hovda K, Nore A, Ekeberg O, et al. Repetition of acute poisoning in Oslo: 1-year prospective study. Br J Psychiatry. 2009;194:73-9 pubmed publisher
    ..Intention was not a significant predictor. Repetition of acute poisoning is high, irrespective of the level of healthcare and the intention behind the poisoning. ..
  45. Gerlock A, Buccheri R, Buffum M, Trygstad L, Dowling G. Responding to command hallucinations to harm: the unpleasant voices scale and harm command safety protocol. J Psychosoc Nurs Ment Health Serv. 2010;48:26-33 pubmed publisher
  46. Moran P, Borschmann R, Flach C, Barrett B, Byford S, Hogg J, et al. The effectiveness of joint crisis plans for people with borderline personality disorder: protocol for an exploratory randomised controlled trial. Trials. 2010;11:18 pubmed publisher
    ..Results of this trial will help to clarify the potential beneficial effects of JCPs for people with BPD and provide information to design a definitive trial. Current Controlled Trials ISRCTN12440268. ..
  47. Latzman R, Gratz K, Young J, Heiden L, Damon J, Hight T. Self-injurious thoughts and behaviors among youth in an underserved area of the Southern United States: exploring the moderating roles of gender, racial/ethnic background, and school-level. J Youth Adolesc. 2010;39:270-80 pubmed publisher
    ..middle-school). Results highlight the need for further research on SITB among diverse youth in underserved areas. ..
  48. Mohamed F, Gawarammana I, Robertson T, Roberts M, Palangasinghe C, Zawahir S, et al. Acute human self-poisoning with imidacloprid compound: a neonicotinoid insecticide. PLoS ONE. 2009;4:e5127 pubmed publisher
    ..Substitution of imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce deaths from self-poisoning. ..
  49. Pérez de Los Cobos J, Trujols J, Ribalta E, Pinet C. A typology of heroin-dependent patients based on their history of self-injurious behaviours. Psychiatry Res. 2009;167:169-77 pubmed publisher
    ..Patients from this cluster probably presented staff members with the main management problems. ..
  50. Perlman S. I do this for your own good: a story of shrieking, disaster and recovery. Am J Psychoanal. 2009;69:330-47 pubmed publisher
    ..The therapist provided special responses, inspired by the work of Sándor Ferenczi, which were found to help the patient discriminate between her parents and the therapist and begin a healing process. ..
  51. Bursztein C, Apter A. Adolescent suicide. Curr Opin Psychiatry. 2009;22:1-6 pubmed publisher
    ..Suicidal behavior remains an important clinical problem and a major cause of death in youth. There are key issues that need to be solved for better prediction of suicidality, prevention and treatment of youth suicide. ..
  52. Kennedy A, Cloutier P, Glennie J, Gray C. Establishing best practice in pediatric emergency mental health: a prospective study examining clinical characteristics. Pediatr Emerg Care. 2009;25:380-6 pubmed publisher
    ..Identifying the clinical characteristics of this population is an important first step toward establishing best practice within an ED. ..
  53. Fliege H, Lee J, Grimm A, Klapp B. Risk factors and correlates of deliberate self-harm behavior: a systematic review. J Psychosom Res. 2009;66:477-93 pubmed publisher
    ..Proximal stressors have rarely been investigated; protective factors, hardly at all. Despite many findings of correlates, the data do not yet justify terming them risk factors. Longitudinal studies are needed. ..