Angelotta Cara
DeWitt Wallace Institute for the History of Psychiatry and Department of Psychiatry, Cornell University New York Presbyterian Hospital, New York, NY.
J Nerv Ment Dis. 2015 Feb;203(2):75-80. doi: 10.1097/NMD.0000000000000243.
Nonsuicidal self-injury (NSSI) is a newly proposed diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Some contemporary historiography dismisses NSSI as a fiction of modern psychiatry. Although the exact definition and psychological meaning attributed to self-harm has not been static over history, there is a clear thread that connects Western asylum psychiatrists' thinking about self-harm to the current stand-alone diagnostic category of NSSI. Nineteenth-century psychiatrists identified a clinically meaningful difference between self-harm with and without the intent to die, between self-injurers who were psychotic and those who were not, and between self-injurers who made a single, serious mutilation and those who repetitively self-injured without causing permanent bodily damage. These same distinctions are apparent in the definition of NSSI. Thus, NSSI is a formalization of long-held observations about a category of people who repetitively self-injure without suicidal intent.
非自杀性自伤（NSSI）是《精神疾病诊断与统计手册》第五版中新提出的诊断类别。一些当代史学著作将非自杀性自伤视为现代精神病学虚构出来的概念。尽管历史上对自我伤害的确切定义和心理意义并非一成不变，但有一条清晰的脉络将西方精神病院的精神病医生对自我伤害的思考与当前独立的非自杀性自伤诊断类别联系起来。19世纪的精神病医生发现了有自杀意图和无自杀意图的自我伤害之间、患有精神病和未患精神病的自我伤害者之间以及单次严重自残的自我伤害者和反复自我伤害但未造成永久性身体损伤的自我伤害者之间在临床上具有重要意义的差异。这些相同的区别在非自杀性自伤的定义中也很明显。因此，非自杀性自伤是对一类反复进行无自杀意图自我伤害的人的长期观察的形式化。
