Department of Psychology, University of Toledo, Toledo, Ohio, USA.
Suicide Life Threat Behav. 2022 Oct;52(5):1024-1036. doi: 10.1111/sltb.12899. Epub 2022 Jul 6.
Nonsuicidal self-injury (NSSI) is defined as the deliberate destruction of one's own body tissue without suicidal intent and for purposes not socially sanctioned. However, this definition limits the understanding and assessment of NSSI by excluding a clinically relevant form of NSSI that is both self-driven and associated with self-injurious intentions: NSSI by proxy. Specifically, we propose that NSSI by proxy be defined as the intentional destruction of one's own body tissue through the elicitation of another being's (e.g., human, animal) actions, wherein the agency of the person being injured is a critical facet of the behavior. We review the literature supporting the clinical relevance of this behavior, as well as its similarities to traditional NSSI. Next, we propose four behaviors that may be conceptualized as NSSI by proxy, and identify two other behaviors that warrant further investigation. Finally, we identify future directions for research in this area and implications for the assessment and treatment of NSSI.
非自杀性自我伤害（NSSI）被定义为没有自杀意图和不被社会认可的目的下，故意破坏自己的身体组织。然而，这个定义通过排除一种具有临床相关性的自我驱动且与自我伤害意图相关的 NSSI 形式来限制了对 NSSI 的理解和评估：代理性自我伤害。具体来说，我们建议将代理性自我伤害定义为通过引起另一个人的（例如，人类、动物）行为来故意破坏自己的身体组织，其中受伤者的行为能力是行为的一个关键方面。我们回顾了支持这种行为的临床相关性的文献，以及它与传统 NSSI 的相似之处。接下来，我们提出了可能被概念化为代理性自我伤害的四种行为，并确定了另外两种值得进一步研究的行为。最后，我们确定了该领域研究的未来方向以及对 NSSI 的评估和治疗的影响。
