Non-Suicidal Self-Injurious Behavior of Childhood/Adolescence

Non-Suicidal Self-Injurious Behavior (NSIB) is the intentional, direct harm or mutilation of body tissue. Outcomes of NSIB includes immediate bodily harm without the intent to die. Research indicates that NSIB can begin in pre-adolescence, while this problem behavior is less common in adulthood. Examples of NSIB include cutting skin, burning one’s body, headbanging with the intention of self-inflicting harm, and punching oneself to cause harm. Adolescents who experience pervasive emotion dysregulation, or teens who have a higher emotional sensitivity to negative emotional responses, can resort to NSIB for stress relief.

NSIB often do not involve a person’s intent to die, but instead, a desire to relieve distress or tension. In other words, NSIB serves as a maladaptive coping strategy to regulate often unwanted emotional states. In treatment, a therapist will help to understand the intent or function of NSIB in order to provide effective treatment. NSIB and suicidal behaviors are treated as very separate treatment targets, primarily because each problem behavior carries a separate purpose or function.

Certain stressors in childhood, including sexual and physical abuse, serve as risk factors for the development of NSIB. Psychotherapy, namely Dialectical Behavior Therapy (DBT), proves instrumental in reducing NSIB. Treatment seeks to identify the function of the NSIB, strengthen the client’s behavioral skills, and establish parental emotion regulation and behavior modification skills. Consultation with a treating psychiatrist is often advised.