Nonsuicidal Self-Injury: A Review of Current Research for Family Medicine and Primary Care Physicians

The Journal of the American Board of Family Medicine

Jennifer J. Muehlenkamp²  Patrick L. Kerr³  James M. Turner¹ 

[1] Departments of Emergency Medicine and Geriatrics, Charleston Area Medical Center, Charleston, West Virginia (JMT);Department of Psychology, University of Wisconsin—Eau Claire (JJM);Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Charleston Division (PLK)

关键词: Nonsuicidal Self-Injury;    Self-Injury;    Risk Assessment;    Behavioral Science;    Psychiatric;    Primary Health Care;    Review;   

DOI  :  10.3122/jabfm.2010.02.090110

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Self-injury is a dangerous behavior that is different from suicidal behavior but is associated with increased risk of suicide attempts. Some effective psychological treatments for self-injury exist. Physicians in family medicine and primary care settings play a vital role as a first step in the treatment process for those who self-injure. Physicians can enhance the care provided to those who self-injure via the accurate assessment of risk, the understanding of the functions of the behavior, assisting the patient in identifying motivations for treatment and treatment options, and provision of long-term behavioral and risk monitoring. This article summarizes the current scientific knowledge regarding the clinical features, epidemiology, assessment methods, and existing treatments of self-injury. The role of the primary care physician in the treatment of patients who self-injure is specifically outlined.

• Nonsuicidal Self-Injury
• Self-Injury
• Risk Assessment
• Behavioral Science
• Psychiatric
• Primary Health Care
• Review

Nonsuicidal self-injury (referred to from here forward as “self-injury”) is any intentional, self-directed behavior that causes immediate destruction of body tissues. This behavior is manifested in a variety of forms, such as cutting, skin carving, burning, severe abrading/scratching, and punching/hitting. Self-injury can also include more severe behaviors, such as bone-breaking and, more rarely, auto-amputation or ocular enucleation.¹ Chronic self-injury is associated with a variety of potential health problems, both psychiatric and somatic, and even occasional superficial self-injury may lead to more serious medical complications.

Empirical research suggests that there is currently a trend toward an increasing prevalence of self-injury, especially among adolescents and young adults.^2,3 This potential increase in prevalence makes it highly likely that general practitioners will become the first point of contact for an increasing number of patients presenting with self-injury. This possibility is made even more probable by the current trend of patients seeking treatment for behavioral disorders from family medicine and primary care physicians (FM/PCPs) first.⁴

Strong emotional reactions to someone's disclosure of self-injury are common and understandable. This is true among the general public, medical professionals in all disciplines, and some behavioral health care providers despite their extensive training in the treatment of behavioral disorders.^5–9 For both mental health care providers and general practitioners, understanding self-injury is a prerequisite for moderating potential negative visceral and emotional responses and for developing an effective plan for treatment. This article provides an introduction to the phenomenon of self-injury and a summary of brief in-office strategies that FM/PCPs can use to help patients who injure themselves.

【 授权许可】

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