Comportamento de autolesão não suicida na adolescência

Abstract

Introduction: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders - DSM-5 defines nonsuicidal self-injury (NSSI) as the act of intentionally injuring one's own body without suicidal intent, typically through cutting, burning, bruising, or scraping, considered a mental health concern when repeated for five days or more. Adolescence is a broad and multidisciplinary concept. The development of individuals during this phase involves changes in social, physical, and psychological spheres. Due to the diverse psychosocial transformations adolescents face, risk factors associated with interpersonal, familial, and social difficulties emerge, alongside challenges in emotion regulation. This study aims to focus on presenting NSSI during adolescence and exploring associated risk factors, as well as the psychological understanding behind maintaining such behaviors. Aware of the depth of discussion regarding the phenomenon of self-injury, with its multiple indicators and approaches to identifying at-risk populations, it is important to note that this study does not aim to exhaust the topic. Instead, it aligns with various scholars in reaffirming the importance of future research to deepen the understanding of the complexities of this behavior. General Objectives: To identify nonsuicidal self-injury in adolescence. Specific Objectives: To characterize self-injury in adolescence; to describe risk factors in adolescence; and to present psychological understandings of self-inflicted behavior. Methodology: This study aimed to present the main theme of self-injury phenomenon during adolescence, essentially conducting a literature review on the topic. The Scientific Electronic Library Online (SCIELO) and Google Scholar were used as platforms to search available references in academic literature. Results and Discussion: In the literature, distinguishing NSSI from suicidal behavior involves considering not only the absence of intent to die but also the low lethality of self-inflicted injuries and the compulsive and repetitive aspects of self-harm. Studies show that the most common form of NSSI involves cutting the surface of the skin, with arms, legs, and wrists being the most frequent locations. Although self-harming behaviors can occur across different age groups, studies confirm a higher incidence during adolescence. Regarding risk factors in adolescence, traumatic situations and the presence of psychological disorders are significant aspects contributing to such behaviors. Additionally, childhood trauma and distress are highlighted in the literature as constitutive elements in the development of emotional regulation. In the socio-familial context, risk factors include issues related to abandonment, violence, substance dependence, bullying, and difficulties in social relationships. Self-directed violence experienced by adolescents is a desperate measure to alleviate psychological suffering. When individuals feel unable to manage negative emotional experiences, they seek ways to interrupt these feelings. Authors indicate that NSSI serves as a means to regulate affect and emotions, stimulating the production of endogenous opioids, particularly endorphins and enkephalins. In the literature, NSSI is commonly associated with tension reduction and emotional control. As noted in studies, the immediate relief experienced as a result of self-injury reinforces this behavior. Intrapsychic and challenging social factors, coupled with difficulties in emotional regulation, tend to drive self-injury practices. The feelings of relief and other mitigating emotions experienced at the time make NSSI a recurring strategy for coping with similar situations. Conclusion: Based on the findings of this study, research on nonsuicidal self-injury plays a crucial role in seeking a deeper understanding of the topic. The factors contributing to self-injury are multidimensional, varying depending on each individual's life context, as well as their family and social dynamics. Moreover, the specific stage of a person's life cycle is also a relevant factor in understanding self-injurious behaviors. Notably, adolescence stands out as a period of increased frequency of NSSI. Characterized by significant changes, challenges, and vulnerabilities, adolescence requires specific skills to address these issues, making it a phase of life deserving special and comprehensive attention when discussing the topic of self-injury.