Self-injury–placement in mental disorders classifications, risk factors and primary mechanisms: Review of the literature.

Self-injury is a common phenomenon among adolescents and young adults, however its
prevalence in clinical population is estimated at 40–80%, especially in regard to patients during
puberty. Symptoms usually appear between 12th and 14th year of age, and their average
duration is approx. 2 years.
According to accepted sociocultural norms self-injury can be regarded as a normal behavior.
Nevertheless, the prevalence of body art phenomenon in Western culture including professional
tattooing, piercing, scarification, burning tattoos and other body modification typical for tribal
cultures, has forced the need to redefine the boundaries for normative behavior.
Introduction of a separate nosological unit of Non-Suicidal Self-Injury in the fifth edition
of DSM classification proves the validity of discussion, being hold for many years, regarding
classification and understanding of the underlying mechanisms of self-harm.
The aim of our study was to present the current state of knowledge regarding self-harm,
with an emphasis on issues devoted to their placement in newest mental disorders classifications
and mechanisms responsible for their development and maintenance. Databases such
as: PubMed, EBSCO (medical and psychological resources) and WEB OF SCIENCE (years
1990–2016) have been screened for the following key words: self-injury, self-harm, selfmutilation,
suicide, deliberate self-harm, affect regulation, NSSI, DSH, personality disorders,
suicide attempt, neurobiology self-harm, DSM-5, adolescent, adults, stress coping styles,
self-mutilation – children, adolescents and adults-prevalence. The analysis indicated 110
articles and 3 textbooks. We have used the following criteria: (1) for the articles presenting
the latest research on risk factors for self-harm we have used the criterion of the study group
number (>30 people) and meta-analyses have been included, (2) for theories explaining the
mechanisms of self-harm criterion of empirical review of the assumptions and the number of
the published studies that verify the theory has been applied.