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Self-harm (SH) or deliberate self-harm (DSH) includes self-injury (SI) and self-poisoning and is defined as the intentional, direct injuring of body tissue most often done without suicidal intentions. These terms are used in the more recent literature in an attempt to reach a more neutral terminology. The older literature, especially that which predates the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), almost exclusively refers to self-mutilation. The term ''self-harm'' is synonymous with the term ''self-injury.'' The most common form of self-harm is skin-cutting but self-harm also covers a wide range of behaviors including, but not limited to, burning, scratching, banging or hitting body parts, interfering with wound healing (dermatillomania), hair-pulling (trichotillomania) and the ingestion of toxic substances or objects.〔 Behaviours associated with substance abuse and eating disorders are usually not considered self-harm because the resulting tissue damage is ordinarily an unintentional side effect. However, the boundaries are not always clearly defined and in some cases behaviours that usually fall outside the boundaries of self-harm may indeed represent self-harm if performed with explicit intent to cause tissue damage.〔 Although suicide is not the intention of self-harm, the relationship between self-harm and suicide is complex, as self-harming behaviour may be potentially life-threatening. There is also an increased risk of suicide in individuals who self-harm〔 to the extent that self-harm is found in 40–60% of suicides. However, generalising self-harmers to be suicidal is, in the majority of cases, inaccurate. The desire to self-harm is listed in the DSM-IV-TR as a symptom of borderline personality disorder. However, patients with other diagnoses may also self-harm, including those with depression, anxiety disorders, substance abuse, eating disorders, post-traumatic stress disorder, schizophrenia, and several personality disorders.〔 Self-harm is also apparent in high-functioning individuals who have no underlying clinical diagnosis.〔 The motivations for self-harm vary and it may be used to fulfill a number of different functions.〔 These functions include self-harm being used as a coping mechanism which provides temporary relief of intense feelings such as anxiety, depression, stress, emotional numbness or a sense of failure or self-loathing and other mental traits including low self-esteem〔See Impression formation.〕 or perfectionism. Self-harm is often associated with a history of trauma and abuse, including emotional and sexual abuse. There are a number of different methods that can be used to treat self-harm and which concentrate on either treating the underlying causes or on treating the behaviour itself. When self-harm is associated with depression, antidepressant drugs and treatments may be effective.〔 Other approaches involve avoidance techniques, which focus on keeping the individual occupied with other activities, or replacing the act of self-harm with safer methods that do not lead to permanent damage. Self-harm is most common in adolescence and young adulthood, usually first appearing between the ages of 12 and 24.〔〔〔 Self-harm in childhood is relatively rare but the rate has been increasing since the 1980s. However, self-harm behaviour can nevertheless occur at any age,〔 including in the elderly population. The risk of serious injury and suicide is higher in older people who self-harm.〔 Self-harm is not limited to humans. Captive animals, such as birds and monkeys, are also known to participate in self-harming behaviour. == Classification == Self-harm (SH), also referred to as ''self-injury'' (SI), ''self-inflicted violence'' (SIV), ''nonsuicidal self injury'' (NSSI) or ''self-injurious behavior'' (SIB), refers to a spectrum of behaviors where demonstrable injury is self-inflicted. The behavior involves deliberate tissue damage that is usually performed without suicidal intent. The most common form of self-harm involves cutting of the skin using a sharp object, e. g. a knife or razor blade. The term ''self-mutilation'' is also sometimes used, although this phrase evokes connotations that some find worrisome, inaccurate, or offensive.〔 ''Self-inflicted wounds'' is a specific term associated with soldiers to describe non-lethal injuries inflicted in order to obtain early dismissal from combat. This differs from the common definition of self-harm, as damage is inflicted for a specific secondary purpose. A broader definition of self-harm might also include those who inflict harm on their bodies by means of disordered eating. Nonsuicidal self injury (NSSI) was added to the DSM-V as its own disorder, which distinguishes it from milder forms of self-harm. This disorder occurs when a person is deliberately harming themselves in a physical way without the intent of committing suicide. Self-harm without suicidal intent can be seen on a spectrum, just like many other disorders (substance abuse, gambling addiction). Just like these other disorders, once the self harming behaviors cross a certain threshold, it then becomes classified as a mental health disorder. 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 be motivated by seeking relief from a negative state, resolving an interpersonal difficulty, or achieving a positive state.〔(【引用サイトリンク】title=Medscape: Medscape Access )〕 A common belief regarding self-harm is that it is an attention-seeking behavior; however, in most 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.〔 They may offer alternative explanations for their injuries, or conceal their scars with clothing. Self-harm in such individuals may not be associated with suicidal or 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 mechanism to relieve emotional pain or discomfort or as an attempt to communicate distress.〔〔 Alternatively, interpretations based on the supposed lethality of a self-harm may not give clear indications as to its intent: life risking behaviour may have no suicidal intent, whilst seemingly superficial cuts may have been a suicide attempt. 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. Some individuals may suffer from dissociation harboring a desire to feel real or to fit into society's rules. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Self-harm」の詳細全文を読む スポンサード リンク
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