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Nonsuicidal self-injury (NSSI) involves deliberate and intentional injury to body tissue that occurs in the absence of suicidal intent. Typical examples here might include self-cutting, burning, or self-hitting. Behavior of this kind is fundamentally unsettling as well as perplexing. It is also the case that self-harming behavior of any kind runs counter to a fundamental survival instinct. In the past, behaviors such as these were viewed as self-mutilation and considered to be a form of attenuated suicide. Much has changed over time, culminating in the entry of NSSI Disorder into DSM-5 as a condition in need of further study. In this review we describe the evolution of the NSSI construct and consider current issues in its diagnosis and assessment.

Abstract Study Objectives The objectives of this study were to examine the relationships between sleep regularity and nonsuicidal self-injury (NSSI), including lifetime NSSI history and daily NSSI urges. Methods Undergraduate students (N = 119; 18–26 years), approximately half of whom endorsed a lifetime history of repetitive NSSI, completed a 10-day actigraphy and ecological momentary assessment (EMA) protocol. A Sleep Regularity Index was calculated for all participants using scored epoch by epoch data to capture rapid changes in sleep schedules. Participants responded to EMA prompts assessing NSSI urge severity and negative affect three times daily over the 10-day assessment period. Results Results indicate that individuals with a repetitive NSSI history were more likely to experience sleep irregularity than those without a history of NSSI. Findings also suggest that sleep irregularity was associated with more intense urges to engage in NSSI on a daily basis, even after accounting for average daily sleep duration, sleep timing, negative affect, and NSSI history. Neither sleep duration nor sleep timing was associated with NSSI history nor daily NSSI urge intensity. Conclusions Findings suggest that sleep irregularity is linked with NSSI, including NSSI history and intensity of urges to engage in NSSI. The present study not only supports the growing evidence linking sleep disturbance with the risk for self-injury but also demonstrates this relationship using actigraphy and real-time assessments of NSSI urge severity. Findings highlight the importance of delineating the nuances in sleep irregularity that are proximally associated with NSSI risk and identifying targets for intervention.

Objective To explore relationship among self‐injury behavior, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self‐injury (NSSI). Methods Cognitive fusion questionnaire (CFQ), Acceptance and Action Questionnaire—2nd edition (AAQ‐II), adolescent nonsuicidal self‐injury behavior questionnaire (ANSAQ), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used as research tools to investigate 120 subjects with NSSI and 130 healthy controls. Results The scores of CFQ and AAQ‐II in the NSSI group were significantly higher than those in the healthy control group (p < .001). The results of regression analysis showed that the experiential avoidance score of patients with NSSI could predict the score of self‐injury questionnaire (β = 0.585, p < .001); when predicting anxiety, only CFQ (β = 0.361, p < .001) entered the equation, with an explanatory variation of 12.3%; when predicting depression, CFQ (β = 0.287, p < .01) entered the equation, with an explanatory variation of 7.4%. Conclusion A high level of cognitive fusion and experiential avoidance may be important factors for the maintenance of self‐injury behavior in patients with NSSI. This study investigated the incidence of postoperative delirium in elderly patients after hip fracture surgery, and to identify risk factors for such, as part of developing a risk stratification index (RSI) system to predict a patient's risk of postoperative delirium.

Self-neglect covers a wide range of behaviours, from neglecting to care for one's personal hygiene and health to one's surroundings; this can include behaviours such as hoarding of objects and/or animals. As presentation of self-neglect cases vary greatly, assessment and support planning should be made on an individualised case by case basis. Self-neglect describes a Risks and Strengths assessment model which has been developed by practitioners as an aid to frontline workers across all sectors, as well as agencies holding responsibilities in Safeguarding Adults. It aims to support and structure the effective, timely and consistent assessment of risk in relation to key social and healthcare factors of self-neglect both on an individual case level and at a strategic level in contributing to community/locality needs analysis and reporting mechanisms; including annual Safeguarding Adults Board Reports.

Background Self‐harm in young people is a serious concern but a deeper understanding of the functions of self‐harm in young people can tailor care and inform new clinical interventions to reduce repeat self‐harm and suicide risk. General practitioners (GPs), as frontline healthcare professionals, have an important role in managing self‐harm in young people. This study aimed to explore the functions of self‐harm in young people and their perspectives on future GP‐led care. Methods A qualitative study using interviews with young people aged between 16 and 25 years with a personal history of self‐harm was conducted. Interviews were transcribed and analysed using reflexive thematic analysis. Findings Four distinct functions were identified: (1) handling emotional states; (2) self‐punishment; (3) coping with mental illness and trauma; and (4) positive thoughts and protection. Young people valued GP‐led support and felt future GP interventions should include self‐help and be personalised. Conclusions These findings support clinicians, including GPs, to explore the functions of self‐harm in young people aged 16–25 in a personalised approach to self‐harm care. It should be noted that self‐harm may serve more than one function for a young person and thus interventions should recognise this. Patient and Public Contribution A group consisting of young people with lived experience of self‐harm, carers, the public, and those who work with young people who harm themselves conceived this study idea, informed recruitment methods and the interview topic guide, and supported the interpretation of findings.

Background Social networking services (SNS) have rapidly become a central platform for adolescents’ social interactions and media consumption patterns. The present study examined a representative sample of publicly accessible content related to deliberate self‐injurious cutting across three SNS platforms: Twitter, Tumblr, and Instagram. Methods Data collection simulated searches for publicly available deliberate self‐injury content on Twitter, Tumblr, and Instagram. Over a six‐month period at randomly generated time points, data were obtained by searching “#cutting” on each SNS platform and collecting the first 10 posts generated. Independent evaluators coded posts for presence of the following: (a) graphic content, (b) negative self‐evaluations, (c) references to mental health terms, (d) discouragement of deliberate self‐injury, and (e) recovery‐oriented resources. Differences across platforms were examined. Results Data collection yielded a sample of 1,155 public posts (770 of which were related to mental health). Roughly 60% of sampled posts depicted graphic content, almost half included negative self‐evaluations, only 9.5% discouraged self‐injury, and <1% included formal recovery resources. Instagram posts displayed the greatest proportion of graphic content and negative self‐evaluations, whereas Twitter exhibited the smallest proportion of each. Conclusions Findings characterize the graphic nature of online SNS deliberate self‐injury content and the relative absence of SNS‐posted resources for populations seeking out deliberate self‐injurious cutting content. Mental health professionals must recognize the rapidly changing landscape of adolescent media consumption, influences, and social interaction as they may pertain to self‐harm patterns.

Aim Nonsuicidal self‐injury is common among adolescents. Dispelling related public misconceptions is essential for creating effective prevention and intervention strategies, as these myths contribute to stigmatization. This study examined the prevalence of self‐injury myths among the Japanese public and explored how demographics and personal experiences influence these beliefs. Methods A nationwide web‐based self‐report survey of 2000 Japanese adults (mean age = 44.6 ± 14.3 years) examined their agreement with 14 scientifically unsupported self‐injury beliefs. Endorsement rates for each myth were calculated, and the associations between myth beliefs and other variables were explored. Results Fourteen myths were analyzed, with endorsement rates of 21.0%–68.7%. Logistic regression analysis indicated that men were more likely to endorse the myth that self‐injury is uncommon (adjusted odds ratio [AOR] = 1.45, 95% confidence interval [CI] = 1.17–1.79), whereas women were more prone to myths about the rarity of self‐injury, using a single method, stimulation as the exclusive purpose, wrist‐cutting prevalence, and average onset age. Younger participants were more likely to believe that self‐injury is solely for stimulation than other age groups. Those with human‐service professional experience were more likely to view self‐injury as attention‐seeking compared to those without such experience (AOR = 1.62, 95% CI = 1.07–2.46). With some exceptions, individuals who expressed confidence in their ability to respond to self‐injurers were more likely to endorse the myths. Conclusion These findings highlight the need for targeted educational interventions to dispel misconceptions about self‐injury and improve public understanding of this complex behavior.

Objective This study was performed to explore the effect of childhood trauma on nonsuicidal self‐injury (NSSI) in adolescents with bipolar II (BD II) depression. Methods Based on the diagnostic criteria of the DSM‐5 and structured interviews to assess the presence or absence of NSSI, 184 adolescent patients with BD II depression were divided into the NSSI (n = 112) and non‐NSSI (n = 72) groups. The Adolescent Nonsuicidal Self‐Injury Assessment Questionnaire (ANSAQ), Childhood Trauma Questionnaire‑Short Form (CTQ‐SF), Toronto Alexithymia Scale (TAS‐20), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA) were used to assess the subjects. Result The CTQ‐SF, HAMD, HAMA, and TAS‐20 scores were significantly higher in the NSSI group than in the non‐NSSI group (p < .01). Logistic regression analysis showed emotional abuse (p = .028, OR = 1.14, 95% CI = 1.01–1.28) and age of onset (p = .009) as risk factors for NSSI. Adolescents with onset age 12–13 years (OR = 6.30, 95% CI = 1.72–23.10) and 14–15 years (OR = 2.24, 95% CI = 1.04–4.84) had a higher risk of self‐injury relative to adolescents aged 16–18 years. Conclusion Childhood trauma and alexithymia were important influencing factors in adolescent patients with BD II depression. Emotional abuse and age of onset as risk factors for NSSI, and difficulties in emotion recognition were positively associated with the patients’ NSSI. We investigated the role of the a prominent serotonin transporter gene polymorphism for autistic traits and internet use disorder. Molecular genetic associations with autistic traits could be observed, but no associations with Internet Use Disorders appeared.

Background This study aims to conduct the first‐ever evaluation of our previously proposed behaviors of “hemomania” in individuals engaged with nonsuicidal self‐injury (NSSI). Methods The study encompassed 130 outpatients engaged with NSSI who applied at the psychiatry outpatient clinic. NSSI behaviors were assessed using the Inventory of Statements About Self‐Injury, while psychiatric diagnoses were evaluated using the Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version. Subsequently, participants completed the Depression Anxiety Stress Scale‐21 and Short Form of Barratt Impulsiveness Scale. Results The prevalence of at least one hemomania behavior including seeing blood, tasting blood, bloodletting, and blood‐drinking was observed to be 43.1% in individuals with NSSI. When participants were divided into two groups, individuals with hemomania exhibited: (1) a higher incidence of psychiatric comorbidities, increased suicide attempts, and more severe symptoms of depression, anxiety, stress, and impulsivity, (2) higher comorbidity rates of borderline personality disorder, body‐focused repetitive behaviors, and dissociative disorders, and (3) elevated frequencies of certain NSSI behaviors, including cutting, biting, needle‐ticking, and carving, compared to those without. Conclusion Hemomania could be considered a specific impulse control disorder, characterized by heightened impulsivity and a persistent urge to obtain one's own blood. However, further studies are needed to validate this hypothesis. This pioneering study investigates hemomania behaviors involving the urge to obtain one's own blood in psychiatry outpatients engaging with NSSI. Among 130 outpatients, 43.1% exhibited at least one hemomania behavior, as shown in the prevalence diagram. Those with hemomania displayed heightened psychiatric comorbidities, increased suicide attempts, and severe symptoms of depression, anxiety, stress, and impulsivity. Elevated rates of certain NSSI behaviors were observed. These findings suggest hemomania's potential classification as an impulse control disorder, warranting further validation and exploration.

Aim Inmates in correctional institutions experience higher rates of suicide attempt (SA), suicidal ideation (SI), and nonsuicidal self‐injury (NSSI) than the general population. This study aimed to examine the association between the Big Five personality traits and suicide‐related behavior, and to estimate the prevalence rate of such behaviors among Japanese institutionalized youth. Methods The participants were 436 youths who had been admitted to four juvenile classification homes (JCHs) between September 2021 and March 2023; they were asked to respond to a self‐report questionnaire after obtaining informed consent. Results A total of 8.1% and 19.3%, 29.4% and 44.7%, and 46.3% and 75.3% of males and females had experienced SA, SI, and NSSI in their lifetime, respectively. Females reported significantly higher instances of suicide‐related behaviors than males considering all suicide‐related behaviors. Logistic regression analyses revealed that neuroticism significantly increased the odds ratios for SA, SI, and NSSI on controlling for sex, age, and number of admissions to JCHs. For NSSI, the odds ratio for agreeableness was significantly lower than 1, indicating a lower probability of NSSI. Conclusion The findings of our study demonstrate that neuroticism, one of the Big Five traits, was consistently and significantly associated with all suicide‐related behaviors, including SA, SI, and NSSI, among youth offenders, while agreeableness was found as a protective factor only against NSSI. The results of this study might help correctional officers identify justice‐involved youth at higher risk for suicide and allow the development of early interventions to prevent suicide. Inmates in correctional institutions experience higher rates of suicide attempt (SA), suicidal ideation (SI), and nonsuicidal self‐injury (NSSI) than the general population. This study aimed to examine the association between the Big Five personality traits and suicide‐related behavior, and to estimate the prevalence rate of such behaviors among Japanese institutionalized youth. Logistic regression analyses revealed that neuroticism significantly increased the odds ratios for SA, SI, and NSSI on controlling for sex, age, and number of admissions to juvenile classification homes.