Non-suicidal Self-injury among Adolescents: Characteristics and Assessment Instruments

Abstract

          Non-Suicidal Self-Injury (NSSI) is a prevalent mental health threat among adolescents. It's found that NSSI rates steadily increase within this demographic. Additionally, adolescents engaging in NSSI behavior are more likely to exhibit suicidal behavior in adulthood. Since adolescence is a vulnerable period characterized by difficulties in emotion and behavior regulation, coupled with insufficient problem-solving, communication, and coping skills compared to adults, ineffective emotional management through self-injury behavior often ensues. NSSI also refers to the act of managing negative emotions through behavior that causes physical harm to the body, without any intention of causing death. This mental health condition has gained recognition in recent years. However, it shares similarities with borderline personality disorder, making diagnosis complex and incomplete. Typically, it's diagnosed alongside self-harm, depression, or suicide attempts. Interviews and history-taking often reveal that self-injury serves as a coping mechanism for anger or dissatisfaction without suicidal intent. In other countries, the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition (DSM-5) is used for diagnosing with clear criteria, which differs from Thailand where the International Statistical Classification of Diseases and Related Health Problems, 10^th Revision (ICD-10) is used, along with no clear assessment instrument suitable for the prevalent Thai adolescent context. Therefore, understanding NSSI among adolescents and emphasizing the importance of assessment and screening are essential for all units involved with adolescents including families, communities, schools, and hospitals. Choosing appropriate instrument for assessing NSSI in adolescents is crucial because accurate and rapid assessments can help screen such behaviors, reduce risk factors, enhance protective factors, monitoring to prevent violence or loss resulting from self-injury can also help intervene with at-risk adolescents promptly and reduce the likelihood of suicidal behavior in adulthood.