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Non-Suicidal Self-Injury - A new diagnosis in DSMV - an article

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Felicity Lee
Felicity Lee

Non-Suicidal Self-Injury - A new diagnosis in DSMV - an article

Post by felicity on 7/4/2012, 7:28 pm

Non-Suicidal Self-Injury: A New Diagnosis?


The Scarred Soul
Understanding and ending self harm.
by Tracy Alderman, Ph.D.

May 2013 is just around the corner (well, sort of) and with that comes the publication of the DSM-5. According to www.dsm5.org the American Psychiatric Association will be releasing the Diagnostic and Statistical Manual - 5 during their 2013 annual meeting in San Francisco, CA.

Of particular interest are two disorders not currently listed in DSM-IV that are being proposed for inclusion in the DSM-5: Non-Suicidal Self Injury and Non-Suicidal Self Injury, Not Otherwise Specified.

According to www.dsm5.org these diagnoses are potentially being defined utilizing the following criteria:

"Non-Suicidal Self Injury

A. In the last year, the individual has, on 5 or more days, engaged in intentional self-inflicted damage to the surface of his or her body, of a sort likely to induce bleeding or bruising or pain (e.g., cutting, burning, stabbing, hitting, excessive rubbing), for purposes not socially sanctioned (e.g., body piercing, tattooing, etc.), but performed with the expectation that the injury will lead to only minor or moderate physical harm. The absence of suicidal intent is either reported by the patient or can be inferred by frequent use of methods that the patient knows, by experience, not to have lethal potential. (When uncertain, code with NOS 2.) The behavior is not of a common and trivial nature, such as picking at a wound or nail biting.


B. The intentional injury is associated with at least 2 of the following:
1. Negative feelings or thoughts, such as depression, anxiety, tension, anger, generalized distress, or self-criticism, occurring in the period immediately prior to the self-injurious act.
2. Prior to engaging in the act, a period of preoccupation with the intended behavior that is difficult to resist.
3. The urge to engage in self-injury occurs frequently, although it might not be acted upon.
4. The activity is engaged in with a purpose; this might be relief from a negative feeling/cognitive state or interpersonal difficulty or induction of a positive feeling state. The patient anticipates these will occur either during or immediately following the self-injury.

C. The behavior and its consequences cause clinically significant distress or impairment in interpersonal, academic, or other important areas of functioning.

D. The behavior does not occur exclusively during states of psychosis, delirium, or intoxication. In individuals with a developmental disorder, the behavior is not part of a pattern of repetitive stereotopies. The behavior cannot be accounted for by another mental or medical disorder (i.e., psychotic disorder, pervasive developmental disorder, mental retardation, Lesch-Nyhan Syndrome).

Potential NOS Categories if DSM-5 adopts subtyping NOS categories:

Non-Suicidal Self-Injury Disorder, Not Otherwise Specified (NOS), Type 1, Subthreshold: The patient meets all criteria for NSSI disorder, but has injured himself or herself fewer than 5 times in the past 12 months. This can include individuals who, despite a low frequency of behavior, frequently think about performing the act.

Non-Suicidal Self-Injury Disorder, Not Otherwise Specified (NOS), Type 2, Intent Uncertain: The patient meets criteria for NSSI but insists that in addition to thoughts expressed in B4 also intended to commit suicide."

taken from - Psychology Today website.



     

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Re: Non-Suicidal Self-Injury - A new diagnosis in DSMV - an article

Post by Guest on 8/8/2012, 11:40 pm

This is interesting. I have a question though. I think about hurting myself sometimes, but usually chicken out. Then, and alter comes forward and says, "Then I'LL do it!" and hits away, to nearly breaking bones. It generally starts because I've done something stupid that I wanna punish myself for. However, I'm chicken and don't generally follow through with any plans. If an alter takes over and plays on my thoughts of wanting to hurt myself, when I don't/won't do it, does that count as having this disorder, or does it still just fall under DID?
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Re: Non-Suicidal Self-Injury - A new diagnosis in DSMV - an article

Post by Guest on 8/8/2012, 11:42 pm

I've NEVER mentioned this problem before, and am really embarrassed about it, but I'm glad that there was a post about it.
Cathie
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Re: Non-Suicidal Self-Injury - A new diagnosis in DSMV - an article

Post by Guest on 8/24/2012, 3:06 pm

Did they just make masochism a mental disorder? While self injury definitely needs addressed for those it creates a problem for, I hate when they take a stab at personal liberties and preferences. Wasn't it the DSM a few publications back that once claimed homosexuality to be a mental illness?


Last edited by SarahKate on 8/24/2012, 3:07 pm; edited 1 time in total (Reason for editing : typo..)
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Old Soul
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Re: Non-Suicidal Self-Injury - A new diagnosis in DSMV - an article

Post by Old Soul on 9/4/2012, 3:43 am

I may be wrong but masochism invovles a level of sexual pleasure caused by pain (and although there is SH that may involve harm to sexual body parts, or sexual acts. I think it is a fine line).

Got to say I am optamistic, maybe they will start treating people with SU/SI behaivours with a little more compassion, instead of viewing it as attention seeking and symptomatic of BPD. Maybe they will look at new ways of treatment and open up more treatment options...

Oh well hope springs forever

OS

kkruty
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Re: Non-Suicidal Self-Injury - A new diagnosis in DSMV - an article

Post by kkruty on 9/4/2012, 3:51 am

glad they are including it. much needed
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Re: Non-Suicidal Self-Injury - A new diagnosis in DSMV - an article

Post by Guest on 9/4/2012, 5:27 am

@Old Soul wrote:I may be wrong but masochism invovles a level of sexual pleasure caused by pain (and although there is SH that may involve harm to sexual body parts, or sexual acts. I think it is a fine line).

Got to say I am optamistic, maybe they will start treating people with SU/SI behaivours with a little more compassion, instead of viewing it as attention seeking and symptomatic of BPD. Maybe they will look at new ways of treatment and open up more treatment options...

Oh well hope springs forever

OS

The definition as it's listed above does not say "except when sexual pleasure is derived"..even though it has plenty of other exceptions. In fact it includes "The activity is engaged in with a purpose... or induction of a positive feeling state" which is pretty much sexual masochism in a nutshell.


Last edited by SarahKate on 9/4/2012, 5:28 am; edited 1 time in total (Reason for editing : my bold doesn't show :/)
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