Editing Self-harm (section)

==Classification and terminology==
''Self-harm'' (SH), ''self-injury'' (SI), ''nonsuicidal self-injury'' (NSSI) and ''self-injurious behavior'' (SIB) are different terms to describe tissue damage that is performed intentionally and usually without suicidal intent.{{sfnm|1a1=McAllister|1y=2003|1p=178|2a1=Plener|2a2=Schumacher|2a3=Munz|2a4=Groschwitz|2y=2015|2p=1|3a1=Butler|3a2=Malone|3y=2013|4a1=Jacobson|4a2=Gould|4y=2007|4p=131}} The adjective "deliberate" is sometimes used, although this has become less common, as some view it as presumptuous or judgmental.{{sfn|NCCMH|2012|loc=[https://www.ncbi.nlm.nih.gov/books/NBK126787/ §&nbsp;2.1.1 Terminology]}} Less common or more dated terms include ''parasuicidal behavior'', ''self-mutilation'', ''self-destructive behavior'', ''self-inflicted violence'', ''self-injurious behavior'', and ''self-abuse''.{{sfn|Connors|1996|p=198}} Others use the phrase ''self-soothing'' as intentionally positive terminology to counter more negative associations.{{sfn|McAllister|2003|p=178}} ''[[Self-inflicted wound]]'' or ''self-inflicted injury'' refers to a broader range of circumstances, including wounds that result from [[organic brain syndrome]]s, [[substance abuse]], and [[autoeroticism]].{{sfn|David|Rifkin|Chiu|2018|p=S82}}

Different sources draw various distinctions between some of these terms. Some sources define ''self-harm'' more broadly than ''self-injury'', such as to include [[drug overdose]], [[eating disorder]]s, and other acts that do not directly lead to visible injuries.<ref>{{harvnb|McAllister|2003|p=178}}: "Some authors differentiate self harm from self injury&nbsp;.... Self harm may be defined as any act that causes psychological or physical harm to the self without a suicide intention, and which is either intentional, accidental, committed through ignorance, apathy or poor judgement. By far the most common form of self harm is drug overdose which requires standard medical management in the first instance. Self injury, on the other hand, is a kind of self harm which leads to visible, direct, bodily injury. Self injury includes cutting, burning, scalding and injurious insertion of objects into the body[.]"</ref> Others explicitly exclude these.{{sfn|NCCMH|2012|loc=[https://www.ncbi.nlm.nih.gov/books/NBK126787/ §&nbsp;2.1.1 Terminology]}} Some sources, particularly in the United Kingdom, define ''deliberate self-harm'' or ''self-harm'' in general to include suicidal acts.{{sfnm|1a1=Jacobson|1a2=Gould|1y=2007|1p=131|2a1=Gillies|2a2=Christou|2a3=Dixon|2a4=Featherston|2y=2018|2pp=4-5}} (This article principally discusses non-suicidal acts of self-inflicted skin damage or self-poisoning.) The inconsistent definitions used for self-harm have made research more difficult.{{sfnm|1a1=Gillies|1a2=Christou|1a3=Dixon|1a4=Featherston|1y=2018|1p=6|2a1=Muehlenkamp|2a2=Claes|2a3=Havertape|2a4=Plener|2y=2012|2pp=1-2|3a1=Butler|3a2=Malone|3y=2013|3p=325}}

Nonsuicidal self-injury (NSSI) is listed in [[DSM-5#Section II: Diagnostic criteria and codes|Section II (''Diagnostic criteria and codes'')]] of the latest, {{As of|2025|April|lc=y}}, edition of the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' ([[DSM-5-TR]]) under the category "other conditions that may be a focus of clinical attention".<ref name=":0">{{cite web |date=2022 |title=Addition of Diagnostic Codes for Suicidal Behavior and Nonsuicidal Self- Injury |website=American Psychiatric Association |url=https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/DSM-5-TR/apa-dsm5tr-suicidalbehaviorandnonsuicidalselfinjury.pdf |access-date=May 23, 2022}}</ref> While NSSI is not a separate mental disorder, the DSM-5-TR adds a diagnostic code for the condition in-line with the [[International Classification of Diseases|ICD]]. The disorder is defined as intentional self-inflicted injury without the intent of dying by suicide. [[DSM-5#Section III: Emerging measures and models|Section III (''Emerging measures and models'')]] of the previous edition of the DSM ([[DSM-5]]) contains the proposed diagnosis along with criteria and description of ''Nonsuicidal Self-injury''.<ref name=":4">{{Cite book |title=Diagnostic and statistical manual of mental disorders: DSM-5 |date=2013 |publisher=American psychiatric association |isbn=978-0-89042-554-1 |edition=5th |location=Washington |pages=803–806 |chapter=Conditions for Further Study}}</ref> Criteria for NSSI include five or more days of self-inflicted harm over the course of one year without suicidal intent, and the individual must have been motivated by seeking [[Relief (emotion)|relief]] from a negative state, resolving an interpersonal difficulty, or achieving a positive state.<ref>{{cite news |vauthors=Stetka BS, Correll CU |date=21 May 2013 |work=Medscape |title=A Guide to DSM-5: Section 3 Disorders |url=https://www.medscape.com/viewarticle/803884_15}}</ref><ref name=":4" />

A common belief regarding self-harm is that it is an [[attention-seeking]] behavior; however, in many cases, this is inaccurate. Many self-harmers are very self-conscious of their wounds and scars and feel guilty about their behavior, leading them to go to great lengths to conceal their behavior from others.<ref name="MHF">{{cite book |title=Truth Hurts Report |isbn=978-1-903645-81-9 |publisher=Mental Health Foundation |year=2006 |url=https://www.mentalhealth.org.uk/explore-mental-health/publications/truth-hurts-report |access-date=2024-03-27}}</ref><ref name=":3">{{cite journal |last1=Burke |first1=Taylor A. |last2=Ammerman |first2=Brooke A. |last3=Hamilton |first3=Jessica L. |last4=Stange |first4=Jonathan P. |last5=Piccirillo |first5=Marilyn |date=November 2020 |title=Nonsuicidal self-injury scar concealment from the self and others |journal=Journal of Psychiatric Research |volume=130 |pages=313–320 |issn=0022-3956 |pmc=10266527 |doi=10.1016/j.jpsychires.2020.07.040 |pmid=32871456}}</ref> They may offer alternative explanations for their injuries, or conceal their scars with clothing.<ref name=":3"/><ref name="spandler">{{cite book |year=1996 |title=Who's Hurting Who? Young people, self-harm and suicide |place=Manchester |publisher=42nd Street |isbn=978-1-900782-00-5 |vauthors=Spandler H}}</ref><ref name="pembroke">{{cite book |veditors=Pembroke LR |year=1994 |title=Self-harm – Perspectives from personal experience |publisher=Chipmunka/Survivors Speak Out |isbn=978-1-904697-04-6 |url=https://archive.org/details/selfharmperspect0000unse |url-access=registration}}</ref> Self-harm in such individuals may not be associated with [[suicide|suicidal]] or [[parasuicide|para-suicidal]] behavior. People who self-harm are not usually seeking to end their own life; it has been suggested instead that they are using self-harm as a [[coping (psychology)|coping mechanism]] to relieve [[emotional pain]] or discomfort or as an attempt to communicate distress.<ref name="fox_hawton"/><ref name="Suyemoto98"/>

Studies of individuals with developmental disabilities (such as [[intellectual disability]]) have shown self-harm being dependent on environmental factors such as obtaining attention or escape from demands.<ref name="iwata">{{cite journal |vauthors=Iwata BA, Dorsey MF, Slifer KJ, Bauman KE, Richman GS |title=Toward a functional analysis of self-injury |journal=Journal of Applied Behavior Analysis |volume=27 |issue=2 |pages=197–209 |year=1994 |pmc=1297798 |doi=10.1901/jaba.1994.27-197 |pmid=8063622}}</ref> Some individuals may have [[dissociation (psychology)|dissociation]] harboring a desire to feel real or to fit into society's rules.<ref>{{cite book |vauthors=Claveirole A, Gaughan M |title=Understanding Children and Young People's Mental Health |year=2011 |publisher=John Wiley & Sons |location=West Sussex, UK |isbn=978-0-470-72345-6 |page=75 |url=https://books.google.com/books?id=FoIFSPnpoNcC&q=dissociation+self+harm&pg=PA75 |access-date=9 February 2011}}</ref>