Do you know NSSI?This behavior of teenagers has attracted widespread attention from scholars

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There is a group of children who said: “When the sharp object cuts my body, I feel calm. I don’t really want to end my life.”

Research shows that non-suicidal self-injury (NSSI) is most common among adolescents and young adults, with the peak age being 12-14 years old. The incidence rate of non-suicidal self-injury behavior among adolescents is 7.5%-46.5%, among college students it is 38.9%, and among adults it is 4%-23%.

The parent said: “The conditions are so good now. I can’t figure out why the child would do such stupid things. He is usually very obedient. Doctor, what’s wrong with my child…”

Fortunately, the vast majority of non-suicidal self-injury behaviors have one characteristic: self-injury is not seeking death, but “survival.” So, what exactly triggered this behavior?

In this issue, Chen Hui, an attending physician in the Department of Clinical Psychology at the First Affiliated Hospital of Tsinghua University, is invited to explain in detail the motivations for non-suicidal self-injury behavior and which teenagers will engage in self-injury behavior.

The incidence of NSSI behaviors is on the rise after the COVID-19 epidemic

Non-suicidal self-injurious behavior is becoming more and more common among adolescents. Especially after the novel coronavirus infection epidemic, the incidence of non-suicidal self-injurious behavior is on the rise. This behavior has gradually attracted widespread attention from domestic and foreign scholars. Concern has become one of the most concerning public health issues in the world.

A desperate move

When a child needs to gain attention or comfort through physical harm, this in itself is an extremely sad thing, and it is a helpless move for them.

In psychiatric outpatient clinics, we often see a group of teenagers who should be youthful and full of youth at the same age as flowers, but they all have sad faces and heavy steps. If you ask them what they do when they are in a bad mood, they will often say that they cut themselves with a knife. “Seeing their wounds bleed makes them feel happy.”

This kind of behavior that harms the body is not seeking attention as ordinary people understand, or it is simply imitation behavior between peers. During the revision process of DSM-5 (American Diagnostic and Statistical Manual of Mental Disorders – 5th edition), this behavior was included in Part III and gave suggested diagnostic criteria for non-suicidal self-injurious behavior.

NSSI behavior is a repeated behavior that directly and intentionally injures one’s own organs and body tissues without the purpose of death, and does not lead to death.

What behaviors are NSSI?

According to current research, there are about 12 common NSSI behaviors, such as cutting, burning, scratching, head banging, hitting, etc. Among them, the proportion of patients who choose one way of self-injury is about 42.3%, and those who choose two and three ways of self-injury account for 28.8% and 13.5% respectively. Research shows that women are more likely to cut and shave, while men are more likely to burn or hit themselves.

What motivates adolescents to commit NSSI behaviors?

A characteristic analysis of 120 cases of adolescent self-injury behavior found that common self-injury motivations of adolescents with NSSI include the following five types: relieving stress or anxiety; controlling oneself and calming down; and having an inability to stop the desire to harm oneself. ; Obtain understanding from others; Deal with sadness and disappointment. It can be seen that for teenagers with NSSI, the common motivation for self-injury is to regulate their emotions.

What kind of adolescents are at risk for NSSI?

The factors that form NSSI behavior are very complex. Risk factors involve demographics, individuals, families, schools and society, etc., and are the result of the joint action of multiple factors.

1. Demographic factors: Domestic and foreign studies have found that the demographic risk factors related to adolescent NSSI are mainly gender and age. In terms of gender, there is more evidence that the detection rate of NSSI in women is significantly higher than that in men. In terms of age, 57% of NSSI first onset is between the ages of 12 and 15, with the peak age between 15 and 16 years old. The incidence rate gradually decreases after the age of 18. Patients over the age of 25 who also develop NSSI are rare, so the overall age trend is “Inverted V” shape.

2. Personal factors: Research has found that teenagers with the following characteristics are more likely to develop NSSI behaviors: those with introverted personality and low self-confidence; those with impulsive, thrill-seeking, and unconventional personalities; those with sexual orientation deviation; those with Internet addiction, Those who engage in irrational behavior such as drinking, substance abuse, and tattoos; those who suffer from mental illness.

3. Family factors: Surveys have found that adolescents who experience childhood abuse, caregiver neglect, excessive parental control, missing family members, and grow up in families with lower economic levels are more likely to develop NSSI.

4. School factors: Campus bullying, study pressure, classmates’ imitation, etc. may become risk factors for NSSI behavior.

5. Social factors: Inappropriate media publicity and bad websites are also high-risk factors that lead to NSSI behaviors among teenagers.

Why does NSSI, which does not cause death, attract academic attention?

Although NSSI behaviors are generally not fatal, they are extremely dangerous. Research has found that low-frequency and small-site NSSI behaviors in children and adolescents are one of the signs of mental health problems in adulthood, while high-frequency and multi-site NSSI behaviors are closely related to suicidal ideation and have been confirmed to be important risk factors for predicting suicide. .

Additionally, NSSI behaviors can occur in a variety of mental disorders. Clinical studies have found that 87.6% of adolescents with NSSI are first diagnosed with mental illnesses, such as depressive disorder, bipolar disorder, attention-deficit and hyperactivity disorder, conduct disorder, borderline personality disorder, eating disorder, etc. The incidence of NSSI in patients with mental disorders is much higher than that in the normal population.

It can be seen that NSSI has become an important mental health problem that seriously affects the physical and mental health of adolescents. It will not only cause pain to individual adolescents, but also impose a heavy burden on families and schools, and requires the attention of the whole society.

Psychiatrist’s Advice

If your child frequently engages in the above-mentioned non-suicidal self-injurious behaviors, or has emotional, sleep and other problems, he must go to the psychiatry/psychology department as soon as possible to obtain professional help and guidance. On the road to facing pain, you and your family do not have to endure it alone. If you have the courage to use professional resources, you will be on the road to hope.

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