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Evidence-Based Treatments of Nonsuicidal Self-Injury

Abstract

Over the past decade, there has been growing concern about nonsuicidal self-injury (NSSI), which refers to deliberate selfharming behaviors aimed at the destruction of one’s own body tissue without suicidal intent. A series of therapeutic interventions have been developed and have verified that NSSI has a higher prevalence than any other mental illness and is a significant obstacle to the biological and social development of individuals. However, from traditional psychotherapy to drug therapy, no specific treatment has been established to date for intervention of NSSI. These findings are consistent across different age groups, but especially for children and adolescents. Even an untrained therapist’s approach seems to contribute to aggravating NSSI. As a result, many researchers have a taken reserved attitude towards the level of effectiveness of certain types of NSSI treatment, but at present significant efforts are being made to establish a set of guidelines for clinicians to ensure the efficiency and compliance of therapeutic intervention of individuals who engage in NSSI.

keywords
자살 의도가 없는 자해, 자기위해, 자해, 근거기반치료, nonsuicidal self-injury, self-injury, self-harm, self-mutilation, evidence-based treatments

Reference

1.

Andover, M. S., Schatten, H. T., Morris, B. W., Holman, C. S., & Miller, I. W. (2017). An intervention for nonsuicidal self-injury in young adults: A pilot randomized controlled trial. Journal of Consulting and Clinical Psychology, 85, 620-631. doi: 10.1037/ccp0000206

2.

Andover, M. S., Schatten, H. T., Morris, B. W., & Miller, I. W. (2015). Development of an intervention for nonsuicidal self-Injury in young adults: An open pilot trial. Cognitive and Behavioral Practice, 22, 491-503. doi: 10.1016/j.cbpra.2014.05.003

3.

Andreasson, K., Krogh, J., Wenneberg, C., Jessen, H. K. L., Krakauer, K., Gluud, C., . . . Nordentoft, M. (2016). Effectiveness of dialectical behavior therapy versus collaborative assessment and management of suicidality treatment for reduction of self-harm in adults with borderline personality traits and disorder—a randomized observer-blinded clinical trial. Depression and Anxiety, 33, 520-530. doi: 10.1002/da.22472

4.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.): Washington, DC: American Psychological Association.

5.

Asarnow, J. R., Hughes, J. L., Babeva, K. N., & Sugar, C. A. (2017). Cognitive-behavioral family treatment for suicide attempt prevention:A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 56, 506-514. doi: https://doi.org/10.1016/j.jaac.2017.03.015

6.

Bjureberg, J., Sahlin, H., Hedman-Lagerlöf, E., Gratz, K. L., Tull, M. T., Jokinen, J., . . . Ljótsson, B. (2018). Extending research on Emotion Regulation Individual Therapy for Adolescents (ERITA) with nonsuicidal self-injury disorder: Open pilot trial and mediation analysis of a novel online version. BMC Psychiatry, 18, 326. doi: 10.1186/s12888-018-1885-6

7.

Bjureberg, J., Sahlin, H., Hellner, C., Hedman-Lagerlöf, E., Gratz, K. L., Bjärehed, J., . . . Ljótsson, B. (2017). Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder:A feasibility study. BMC Psychiatry, 17, 411. doi: 10.1186/s12888-017-1527-4

8.

Brent, D. A., Emslie, G. J., Clarke, G. N., Asarnow, J., Spirito, A., Ritz, L., . . . Keller, M. B. (2009). Predictors of spontaneous and systematically assessed suicidal adverse events in the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) study. American Journal of Psychiatry, 166, 418-426. doi: 10.1176/appi.ajp.2008.08070976

9.

Bresin, K., & Schoenleber, M. (2015). Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clinical Psychology Review, 38, 55-64. doi: https://doi.org/10.1016/j.cpr.2015.02.009

10.

Briggs, S., Netuveli, G., Gould, N., Gkaravella, A., Gluckman, N. S., Kangogyere, P., . . . Lindner, R. (2019). The effectiveness of psychoanalytic/psychodynamic psychotherapy for reducing suicide attempts and self-harm: Systematic review and meta-analysis. The British Journal of Psychiatry, 214, 320-328. doi: 10.1192/bjp. 2019.33

11.

Brown, R. C., & Plener, P. L. (2017). Non-suicidal self-injury in adolescence. Current Psychiatry Reports, 19, 20. doi: 10.1007/s11920-017-0767-9

12.

Cipriano, A., Cella, S., & Cotrufo, P. (2017). Nonsuicidal self-injury: A systematic review. Frontiers in Psychology, 8, 1946. doi: 10.3389/fpsyg.2017.01946

13.

Garisch, J. A., Wilson, M. S., O’Connell, A., & Robinson, K. (2017). Overview of assessment and treatment of non-suicidal self-injury among adolescents. New Zealand Journal of Psychology, 46, 98-105.

14.

Gonzales, A. H., & Bergstrom, L. (2013). Adolescent Non-Suicidal Self-Injury (NSSI) Interventions. Journal of Child and Adolescent Psychiatric Nursing, 26, 124-130. doi: 10.1111/jcap.12035

15.

Gratz, K. L., Breetz, A., & Tull, M. T. (2010). The moderating role of borderline personality in the relationships between deliberate self‐harm and emotion‐related factors. Personality and Mental Health, 4, 96-107.

16.

Gratz, K. L., Chapman, A. L., Dixon-Gordon, K. L., & Tull, M. T. (2016). Exploring the association of deliberate self-harm with emotional relief using a novel implicit association test. Personality Disorders-Theory Research and Treatment, 7, 91-102. doi: 10. 1037/per0000138

17.

Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior Therapy, 37, 25-35.

18.

Gratz, K. L., Tull, M. T., & Levy, R. (2014). Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Psychological Medicine, 44, 2099-2112.

19.

Greenberg, L. S. (2015). Emotion-focused therapy: Coaching clients to work through their feelings (2nd ed.). Washington DC: American Psychological Association.

20.

Guérin-Marion, C., Martin, J., Deneault, A. A., Lafontaine, M. F., & Bureau, J. F. (2018). The functions and addictive features of nonsuicidal self-injury: A confirmatory factor analysis of the Ottawa self-injury inventory in a university sample. Psychiatry Research, 264, 316-321. doi: https://doi.org/10.1016/j.psychres.2018.04.019

21.

Guthrie, E., Patton, G. C., Kapur, N., Mackway-Jones, K., Chew- Graham, C., Moorey, J., . . . Tomenson, B. (2001). Randomised controlled trial of brief psychological intervention after deliberate self poisoning. British Medical Journal, 323, 135-138. doi:10.1136/bmj.323.7305.135

22.

Harrington, R., Kerfoot, M., Dyer, E., McNiven, F., Gill, J., Harrington, V., . . . Byford, S. (1998). Randomized trial of a home-based family intervention for children who have deliberately poisoned themselves. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 512-518.

23.

Hawton, K., Witt, K. G., Salisbury, T. L. T., Arensman, E., Gunnell, D., Hazell, P., . . . van Heeringen, K. (2016). Psychosocial interventions following self-harm in adults: A systematic review and meta-analysis. The Lancet Psychiatry, 3, 740-750. doi: 10.1016/S2215-0366(16)30070-0

24.

Hawton, K., Witt, K. G., Salisbury, T. L. T., Arensman, E., Gunnell, D., Hazell, P., . . . van Heeringen, K. (2018). Pharmacological interventions for self-harm in adults. BJPsych Advances, 22, 2-2. doi: 10.1192/apt.22.1.2

25.

Hawton, K., Witt, K. G., Salisbury, T. L. T., Arensman, E., Gunnell, D., Townsend, E., . . . Hazell, P. (2015). Interventions for self‐harm in children and adolescents. Cochrane Database of Systematic Reviews. doi: 10.1002/14651858.CD012013

26.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York, US: Guilford Press.

27.

Hazell, P. L., Martin, G., McGill, K., Kay, T., Wood, A., Trainor, G., & Harrington, R. (2009). Group therapy for repeated deliberate self-harm in adolescents: Failure of replication of a randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 662-670. doi: https://doi.org/10.1097/CHI.0b013e-3181aOacec

28.

Hetrick, S. E., Robinson, J., Spittal, M. J., & Carter, G. (2016). Effective psychological and psychosocial approaches to reduce repetition of self-harm: A systematic review, meta-analysis and metaregression. BMJ Open, 6, e011024. doi: 10.1136/bmjopen-2016-011024

29.

Kim, S., Kim, Y., & Hur, J. W. (2019). Nonsuicidal self-injury among Korean young aults: A validation of the Korean version of the Inventory of Statements about Self-Injury. Psychiatry Investigation, 16, 270-278. doi: 10.30773/pi.2019.01.23

30.

Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27, 226-239. doi: 10.1016/j.cpr.2006.08.002

31.

Klonsky, E. D. (2011). Non-suicidal self-injury in United States adults:Prevalence, sociodemographics, topography and functions. Psychological Medicine, 41, 1981-1986. doi: 10.1017/S00332917-10002497

32.

Klonsky, E. D., & Glenn, C. R. (2009). Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS). Journal of Psychopathology and Behavioral Assessment, 31, 215-219.

33.

Klonsky, E. D., Glenn, C. R., Styer, D. M., Olino, T. M., & Washburn, J. J. (2015). The functions of nonsuicidal self-injury: Converging evidence for a two-factor structure. Child and Adolescent Psychiatry and Mental Health, 9(1), 44. doi: 10.1186/s13034-015-0073-4

34.

Kwon, H., & Kwon, S. (2017). Validation study of the Korean version of the Functional Assessment of Self-Mutilation (FASM). Clinical Psychology in Korea: Research and Practice, 3, 187-205.

35.

Linehan, M. (1993). Skills training manual for treating borderline personality disorder (Vol. 29): New York, NY: Guilford Press.

36.

Linehan, M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., . . . Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63, 757-766. doi:10.1001/archpsyc.63.7.757

37.

Linehan, M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., . . . Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: A randomized clinical trial and component analysis. JAMA Psychiatry, 72, 475-482. doi: 10.1001/jamapsychiatry. 2014.3039

38.

Lloyd, E., Kelley, M., & Hope, T. (1997). Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates. Paper presented at the annual meeting of the Society for Behavioral Medicine, New Orleans, LA.

39.

Lloyd-Richardson, E. E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine, 37, 1183-1192. doi: 10.1017/s003329170700027x

40.

McCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., . . . Linehan, M. M. (2018). Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: A randomized clinical trial. JAMA Psychiatry, 75, 777-785. doi: 10.1001/jamapsychiatry.2018.1109

41.

McMain, S. F., Guimond, T., Barnhart, R., Habinski, L., & Streiner, D. L. (2017). A randomized trial of brief dialectical behaviour therapy skills training in suicidal patients suffering from border line disorder. Acta Psychiatrica Scandinavica, 135, 138-148. doi:10.1111/acps.12664

42.

Mehlum, L., Ramberg, M., Tørmoen, A. J., Haga, E., Diep, L. M., Stanley, B. H., . . . Grøholt, B. (2016). Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: Outcomes over a one-year follow-up. Journal of the American Academy of Child &Adolescent Psychiatry, 55, 295-300. doi: https://doi.org/10.1016/j.jaac.2016.01.005

43.

Mehlum, L., Tørmoen, A. J., Ramberg, M., Haga, E., Diep, L. M., Laberg, S., . . . Grøholt, B. (2014). Dialectical Behavior Therapy for adolescents with repeated suicidal and self-harming behavior:A randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 53, 1082-1091. doi: https://doi.org/10.1016/j.jaac.2014.07.003

44.

Morgan, H. G., Pocock, H., & Pottle, S. (1975). The urban distribution of non-fatal deliberate self-harm. British Journal of Psychiatry, 126, 319-328. doi: 10.1192/bjp.126.4.319

45.

Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339-363. doi: 10.1146/annurev.clinpsy.121208.131258

46.

Nock, M. K. (2014). The Oxford handbook of suicide and self-injury. New York, NY: Oxford University Press.

47.

Nock, M. K., Prinstein, M. J., & Sterba, S. K. (2009). Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults. Journal of Abnormal Psychology, 118, 816-827. doi:10.1037/a0016948

48.

Ougrin, D., Tranah, T., Stahl, D., Moran, P., & Asarnow, J. R. (2015). Therapeutic interventions for suicide attempts and self-harm in adolescents: Systematic review and Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 97-107. e102. doi: https://doi.org/10.1016/j.jaac.2014.10.009

49.

Pistorello, J., Fruzzetti, A. E., Maclane, C., Gallop, R., & Iverson, K. M. (2012). Dialectical behavior therapy (DBT) applied to college students: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 80, 982-994. doi: 10.1037/a0029096

50.

Plener, P. L., Brunner, R., Fegert, J. M., Groschwitz, R. C., In-Albon, T., Kaess, M., . . . Becker, K. (2016). Treating nonsuicidal self-injury (NSSI) in adolescents: consensus based German guidelines. Child and Adolescent Psychiatry and Mental Health, 10, 46. doi:10.1186/s13034-016-0134-3

51.

Plener, P. L., Libal, G., Fegert, J. M., & Kölch, M. G. (2013). Psychopharmakologische Behandlung von nicht suizidalem selbstverletzendem Verhalten. [Psychopharmacological treatment of nonsuicidal self-injury]. Nervenheilkunde, 32, 38-41. doi: 10.1055/s-0038-1628475

52.

Rootes-Murdy, K., Carlucci, M., Tibbs, M., Wachtel, L. E., Sherman, M. F., Zandi, P. P., & Reti, I. M. (2019). Non-suicidal self-injury and electroconvulsive therapy: Outcomes in adolescent and young adult populations. Journal of Affective Disorders, 250, 94- 98. doi: https://doi.org/10.1016/j.jad.2019.02.057

53.

Rossouw, T. I., & Fonagy, P. (2012). Mentalization-based treatment for self-harm in adolescents: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 1304-1313.e1303. doi: https://doi.org/10.1016/j.jaac.2012.09.018

54.

Slee, N., Garnefski, N., van der Leeden, R., Arensman, E., & Spinhoven, P. (2008). Cognitive-behavioural intervention for selfharm:randomised controlled trial. British Journal of Psychiatry, 192, 202-211. doi: 10.1192/bjp.bp.107.037564

55.

Tolin, D. F., McKay, D., Forman, E. M., Klonsky, E. D., & Thombs, B. D. (2015). Empirically supported treatment: Recommendations for a new model. Clinical Psychology: Science and Practice, 22, 317-338. doi: 10.1111/cpsp.12122

56.

Turner, B. J., Austin, S. B., & Chapman, A. L. (2014). Treating nonsuicidal self-injury: A systematic review of psychological and pharmacological interventions. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 59, 576-585. doi: 10.1177/0706-74371405901103

57.

Verheul, R., Van Den Bosch, L. M. C., Koeter, M. W. J., De Ridder, M. A. J., Stijnen, T., & Van Den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder:12-month, randomised clinical trial in the Netherlands. British Journal of Psychiatry, 182, 135-140. doi: 10.1192/bjp.182.2.135

58.

Wood, A., Trainor, G., Rothwell, J., Moore, A., & Harrington, R. (2001). Randomized trial of group therapy for repeated deliberate self-harm in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1246-1253. doi: 10.1097/00004583-200111000-00003

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