Abstract
Nonsuicidal self-injury (NSSI) and suicidal behaviors, both important issues in adolescent health care, are frequently associated and possibly clinically related. Our objective was to explore the views of relations between nonsuicidal self-injury and suicidal behaviors during adolescence and young adulthood (11–25 years) expressed in the scientific (medical and psychological) literature. We adopted a textual approach to the process of synthesis to tell the story of the findings from the included studies. Our narrative systematic review of 64 articles found that they share the same risk factors. Integrated models envision nonsuicidal self-injury as a gateway enabling teens to acquire the capability for suicide. Because suicidal behavior short-circuits thought, it is difficult to conceive an intention to die during adolescents' acts of self-injury. Intention is constructed by the narrative of the act, influenced by numerous elements from the psychopathologic, cultural, religious, and philosophic context. Techniques of mentalizing-based treatments and work on the meaning that adolescents attribute to their behaviors might improve care.
Highlights
IntroductionNonsuicidal self-injurious behavior (NSSI), referred to as self-mutilation (for example, cutting, burning or hitting oneself, scratching oneself to the point of bleeding and interfering with healing) is a relatively frequent behavior in adolescents and young adults (jointly described hereafter as young people [1]) and is reported to affect around 10% of them [2–6]
Nonsuicidal self-injurious behavior (NSSI), referred to as self-mutilation is a relatively frequent behavior in adolescents and young adults and is reported to affect around 10% of them [2–6]
We examined 64 studies that questioned relations between NSSI and suicidal behaviors in adolescence and young adulthood
Summary
Nonsuicidal self-injurious behavior (NSSI), referred to as self-mutilation (for example, cutting, burning or hitting oneself, scratching oneself to the point of bleeding and interfering with healing) is a relatively frequent behavior in adolescents and young adults (jointly described hereafter as young people [1]) and is reported to affect around 10% of them [2–6]. In the United States, the mean prevalence of NSSI in the clinical population of hospitalized adolescents is around 35% [4,12–14], while its prevalence in the general population of teens is thought to be around 10% [2–6] Some of these adolescents present recurrent NSSI behavior [8,15]. Many authors identify adolescence as a period at risk for NSSI behavior: it begins most often during puberty, at the age of 13 to 15 years [4,16,17], and its prevalence falls in adulthood [18]. Girls begin this type of behavior earlier than boys [19] and are at higher risk during adolescence [2,20]. Studies show that the incidence of NSSI in western countries is highest among white male adolescents [18,23]
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