title: Defining and refining self-harm: a historical perspective on nonsuicidal self-injury.
abstract: 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.
authors.affiliation: DeWitt Wallace Institute for the History of Psychiatry and Department of Psychiatry, Cornell University New York Presbyterian Hospital, New York, NY.
authors.forename: Cara
authors.initials: C
authors.lastname: Angelotta
mesh_terms: D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D016728:Self-Injurious Behavior / Q000145:classification* / Q000266:history*