Talk:Self-harm/Archive 5

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Genetics

There is a section on genetics and it has an expansion template on it. However, can this section really be expanded? What do we know about the link between genetics and self-harm. Is there really anything we can say here? If not we shouldn't have the section at all and the one sentence in it should just be merged in the causes section. Jdrewitt (talk) 19:20, 17 January 2010 (UTC)

Well the sentence on LNS could be expanded to a brief overview. Also this is an excellent review of self harm published in the Lancet in 05. Discusses genetics. If you need access turn on you email and I will send you a copy.Doc James (talk · contribs · email) 19:48, 17 January 2010 (UTC)

Autism also has a genetic basis and is mentioned in the article. Also, an alternative to expanding the section is merging it with other material. Geometry guy 20:44, 17 January 2010 (UTC)

Do you mean the Skegg 2005 Lancet review? In which case I have it, just hadn't read the genetics section, but thanks for pointing it out. Consulting the review paper I see that yes, there certainly is room from expansion on the topic of genetics. Jdrewitt (talk) 20:52, 17 January 2010 (UTC)

Yes that is the one I mean.Doc James (talk · contribs · email) 20:59, 17 January 2010 (UTC)

I expanded the section very slightly...Jdrewitt (talk) 23:23, 22 January 2010 (UTC)

With regards to autism, I'm not sure how more at risk someone with autism is to intentional self-harm as defined in this article than someone without autism? Will have to check the references before this link can really be stated. Jdrewitt (talk) 10:35, 23 January 2010 (UTC)

File:22Scars.jpg

After this statement by the editor who removed this image from the article, I have put the image back in. Fake or not fake it can be discussed here. If the image is deemed unsuitable then it will be removed but here all users will get a say and no one will be belittled. Jdrewitt (talk) 23:01, 22 January 2010 (UTC)

The image's authenticity needs to be established before it is included in this article. There's no "belittling" going on, just a little bit of that all too uncommon common sense. --Malleus Fatuorum 23:05, 22 January 2010 (UTC)

::You said the article is "a piece of shit" so what are you doing here, you're not welcome with that attitude here or anywhere else on wikipedia. I suggest you log off for today and keep away from SH for a while. Currently consensus is not with you so please stop reverting other people's edits. It would make "commonsense" to listen to what others have to say instead of forcing your opinion. You might be right but your attitutde is wrong. Jdrewitt (talk) 23:11, 22 January 2010 (UTC)

I see that I'm outnumbered.[6] So play your silly games. --Malleus Fatuorum 23:13, 22 January 2010 (UTC)

Its not about being outnumbered and its not about playing games. Its about respect for the article and its editors. Jdrewitt (talk) 23:21, 22 January 2010 (UTC)

I think the article is poor, and have no qualms about saying so no matter who's upset by that. What I'm more concerned about right now though is your insistence on the inclusion of a clearly faked image, apparently because I upset you by not being sweet enough. I call that dishonesty. You can call it whatever you like. --Malleus Fatuorum 23:27, 22 January 2010 (UTC)

I reverted the removal of the image so that discussion could be had here at the appropriate place and other editors opinions could get heard. It wasn't a straight forward decision as other editors (not including myself) objected to the removal so it has to be discussed first. Jdrewitt (talk) 23:32, 22 January 2010 (UTC)

More dishonesty. The discussion could have been had with or without the inclusion of the faked image in this article. --Malleus Fatuorum 23:39, 22 January 2010 (UTC)

The best course of action in my opinion was to revert the article to its original state until the issue was resolved. Jdrewitt (talk) 23:44, 22 January 2010 (UTC)

I am not entirely happy with this image either. The quality is poor. The person who uploaded it does not give any description. It does look like it could have been made with a marker. Also please see WP:CIVIL. Maybe we should request clarification from the up-loader?Doc James (talk · contribs · email) 23:16, 22 January 2010 (UTC)

In terms of image quality I agree it is not great. Whether or not it is faked is debatable but I think its too poor resolution to tell for sure. Jdrewitt (talk) 23:21, 22 January 2010 (UTC)

(ec, general comment) This article talk page is the right place to discuss whether this image should be used, not a user talk page. Similarly, discussion of user conduct does not belong here. Nevertheless, I agree with the preliminary consensus that the image is too blurred to determine for sure whether it represents actual self-harm or an illustration thereof. There is no original research on Wikipedia. Geometry guy 23:26, 22 January 2010 (UTC)

PS. For what its worth (and my comment contains unsourced opinion): if the image does indeed represent self-harm, it looks to me like a large number of small punctures, not the cursive cutting which Malleus seems to have suggested on his talk page. I would imagine it is much easier to form a visible shape with minimal scarring using many small punctures than it is through cursive knife cuts. This does not require considerable skill, as each puncture can be made fairly precisely. Geometry guy 23:46, 22 January 2010 (UTC)

In general Geometry guy your unbiased opinions are worth a great deal! I guess its possible but I think it is more likely to be cursive cutting. With a sharp enough blade it isn't be a problem cutting shapes. The cuts, if they are cuts, aren't too deep so the pain would likely be bearable enough to concentrate. The biggest thing for these images being real is the colour variations along the lettering, the darker areas indicate deeper cuts. It won't necessarily be a uniform depth all the way along the cut and I think these patterns are very indicative of variations of applied pressure. As Doc James says someone should ping the uploader and if we don't receive clarification then we can't really use the image. TBH a clearer image would be a lot better anyway but obtaining suitable images for this article is quite difficult and it has been the topic of several archived threads. Jdrewitt (talk) 00:39, 23 January 2010 (UTC)

Indicative of using applied pressure on the airspray tool, I agree. --Malleus Fatuorum 00:48, 23 January 2010 (UTC)

But you have no way of knowing that for sure and have not justified you "opinions" adequately. I also want to make it clear that despite your sarcasm we are not in agreement. Jdrewitt (talk) 08:39, 23 January 2010 (UTC)

I see cases fairly frequently. We have one image now in the lead and I am not sure a second one really adds anything.Doc James (talk · contribs · email) 01:34, 23 January 2010 (UTC)

Ok Doc, I will remove the image. Jdrewitt (talk) 08:07, 23 January 2010 (UTC)

On the basis that it's resolution is poor and it does not really add to the article. Any discussion on its authenicity from now on should be conducted on the image talk page. Jdrewitt (talk) 08:56, 23 January 2010 (UTC)

Well it looks like Wikipedia review has commented on the image. [7] we have someone who claims to have made this image.Doc James (talk · contribs · email) 06:18, 28 January 2010 (UTC)

Reviews

This looks like an interesting review Greydanus DE, Shek D (2009). "Deliberate self-harm and suicide in adolescents" (PDF). Keio J Med. 58 (3): 144–51. PMID 19826208. {{cite journal}}: Unknown parameter |month= ignored (help) Doc James (talk · contribs · email) 16:41, 23 January 2010 (UTC)

wow great find--Guerillero (talk) 02:26, 26 January 2010 (UTC)

I think this is a useful review. However, I am concerned about the accuracy of their conclusions particularly in the statment "Deliberate self-harm is a widespread yet often hidden problem in adolescents, especially females" which seems to suggest it is only adolescent females. I think this is a biased and inaccurate statement - based on my review of other literature that suggest otherwise. Nevertheless I think it is a good review and does provide some useful citations, e.g. Zahl DL, Hawton K: Repetition of self-harm and subsequent suicide risk: long-term follow-up study of 11, 583 patients. Brit J Psychia 2004; 185: 70－75 in which a study was made of 11,583 patients with deliberate self-harm in Oxford, England from 1978 to 1997. This I think is a reasonably sized sample on which to base findings - I have yet to read the paper but of course there is always the issue that no matter how large the sample size it won't include patients who choose to conceal their injuries, as is mentioned but may need to be clarified some more in our article. Jdrewitt (talk) 17:50, 3 February 2010 (UTC)

To back up my assertion see e.g. Bowen and John, Counselling Psychology Quarterly, Vol. 14, No. 4, 2001, pp. 357–379 in which the gender bias is discussed and states that the frequency amoung males and females is relatively comparable. Jdrewitt (talk) 18:00, 3 February 2010 (UTC)

DSM V

Self harm may be added to DSM V under the name of Nonsuicidal self injury (NSSI). DSM5 page full proposal--Guerillero | My Talk 18:14, 12 February 2010 (UTC)

Suggestion regarding terminology

The condition referred to in the section http://en.wikipedia.org/wiki/Self-harm#Mental_illness as "Munchausen Syndrome" is properly termed "factitious disorder" (which is in turn broken into three separate subcategories), according to the DSM-IV-TR. I suggest that the wording be altered accordingly and linked to the FD page (which really ought to be merged with the Munchausen article, but that's another matter). Rapunzel676 (talk) 02:13, 23 February 2010 (UTC)

Well yes Munchausens in a factitius disorder however factious disorder is not munchausens. For example "Factitious illness may have a broad spectrum of presentations. In its milder forms, there may be only an exaggeration of physical symptoms. The most extreme and dramatic form is called Munchausen syndrome, first described by Asher.".Ehrlich S, Pfeiffer E, Salbach H, Lenz K, Lehmkuhl U (2008). "Factitious disorder in children and adolescents: a retrospective study". Psychosomatics. 49 (5): 392–8. doi:10.1176/appi.psy.49.5.392. PMID 18794507.{{cite journal}}: CS1 maint: multiple names: authors list (link) --Doc James (talk · contribs · email) 02:24, 23 February 2010 (UTC)

I am well aware of the fact that a factitious disorder is not the same as Münchausen's syndrome, as I have access to the full DSM-IV-TR. While the DSM does refer to Münchausen's syndrome as "the most extreme and chronic form [emphasis added] of factitious disorder," it still falls under the subtype of Factitious Disorder With Predominantly Physical Signs and Symptoms (and the term Münchausen's syndrome is, curiously, put in quotation marks in the DSM entry, which makes me wonder if its use is more colloquial than clinical, but that is neither here nor there.) Deliberate self-harm, however mild, is a defining feature of Factitious Disorder With Predominantly Physical Signs and Symptoms, as the text of the entry indicates:

The essential feature of Factitious Disorder is the intentional production of physical or psychological signs or symptoms (Criterion A). The presentation may include fabrication of subjective complaints (e.g., complaints of acute abdominal pain in the absence of any such pain), falsification of objective signs (e.g., manipulating a thermometer to create the illusion of fever), self-inflicted conditions (e.g., the production of abscesses by injection of saliva into the skin), exaggeration or exacerbation of preexisting general medical conditions (e.g., feigning of a grand mal seizure by an individual with a previous history of seizure disorder), or any combination or variation of these.

I believe the text of the article should substitute the broader term while indicating that Münchausen's is merely the most severe form. I should note that while I accessed the DSM through an online subscription service, it is readily available in print format: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), 2000 American Psychiatric Association.. Please excuse me if I didn't get the citation format quite right, as I am a relatively new editor. I can cite the online source if necessary. Rapunzel676 (talk) 21:42, 23 February 2010 (UTC)

Yes agree and do not see any problem with this.Doc James (talk · contribs · email) 21:46, 23 February 2010 (UTC)

If you want to generalize that section you could go to an extreme and say

The key areas of illness which exhibit an increased risk include depression, Anxiety disorders, and conduct disorders. Substance abuse is also considered a risk factor as are some personal characteristics such as poor problem solving skills and impulsivity. There are parallels between self-harm and factitious disorders, a group of psychiatric disorders where those affected feign illness or trauma.

I don't have a copy of DSM IV but are there other factitious disorders besides Munchausen syndrome? The page doesn't describe other disorders that self harm would be a symptom of? --Guerillero | My Talk 02:08, 24 February 2010 (UTC)

Trichotillomania

As someone who has this disorder, I find it insulting that it is included on this Wikipedia page. In my opinion and the opinion of many others, it is not a form of self-harm or self-injury. Having it listed as a form of self-harm is incorrect and misleading. —Preceding unsigned comment added by 97.100.16.187 (talk) 05:11, 13 March 2010 (UTC)

Trichotillomania is listed as a form of self-harm in a large number of the sources that are cited in this article. Specifically in the signs and symptons section the references cited are the Mental Health Foundation Truth hurts report, which you can download here, and the firstsigns website here. I'm sorry that you feel insulted by the classification but it is not misleading to list Trichotillomnia as a form of self-harm. Jdrewitt (talk) 07:49, 13 March 2010 (UTC)

I agree with Jdrewitt. We should go with the published literature.Doc James (talk · contribs · email) 19:46, 15 May 2010 (UTC)

In arts and entertainment section removed

Hi all,

I have removed a recently added section, it is wholly uncited and I think needs consensus here before inclusion anyway. In the talk archives I remember there is a thread discussing the inclusion of examples from popular culture and famous people who self-harm etc. and I think the overall consensus was that this content is not suitable. I include the removed section below:

• In the video game Devil May Cry 3, Vergil cuts the palm of his hand in order to provide a blood offering to break the Temen-ni-gru's seal.

• In Family Guy, it is revealed that Meg cuts herself. She also pulls one of her own teeth out when she finds out about Lois seducing her boyfriend.

• In American Dad!, Francine Smith recalls an incident where she use to cut herself for the attention of a principal.

• In Dante's Inferno, Dante stitches a tapestry into his own chest as punishment for his war crimes.

• In Orphan, the serial killer Esther breaks her own arm to get John's sympathy.

• In Persona 3, the character Chidori is revealed to have a tendency to self-mutilate, much to Junpei's horror.

Jdrewitt (talk) 07:26, 29 March 2010 (UTC)

What is WP's policy on "in pop culture' sections? IMHO they seem to be attractors of garbage. I wouldn't call any of the above examples notable either. --Guerillero | My Talk 19:44, 29 March 2010 (UTC)

here is the past discussions of this Talk:Self-harm/Archive_1#Music The AFD for SI in pop culture --Guerillero | My Talk 19:50, 29 March 2010 (UTC)

There are so many examples in popular culture and famous people with the condition that it would be endless hours debating who to include. I agree it would be problematic to include that section. Alatari (talk) 13:26, 8 April 2010 (UTC)

See also WP:TRIVIA for the wikipedia guidelines on trivia sections. Jdrewitt (talk) 13:44, 8 April 2010 (UTC)

If Meninger, Ross or Macay knew some presidents wife or other famous person that funded their studies; that would be a juicy tidbit IMO. This article is well structured and it would be better that the link to this article be made at the Family Guy 'Meg' episode article and not here. BTW, I like the new animal section. Good work. Alatari (talk) 14:02, 8 April 2010 (UTC)

A good recent review of the topic

[8] Doc James (talk · contribs · email) 14:27, 28 April 2010 (UTC)

I will have a look --Guerillero | My Talk 23:22, 29 April 2010 (UTC)

Thanks for the link. Polyamorph (talk) 18:27, 15 May 2010 (UTC)

I have included a citation to the reference in the epidemiology section, use <ref name=kerr2010/> for further citations. Best wishes Polyamorph (talk) 19:00, 15 May 2010 (UTC)

Why not include some recovery tips? I think it would be both informative and useful. —Preceding unsigned comment added by 75.42.178.138 (talk) 00:22, 30 April 2011 (UTC)

Autosadism

Followers of this topic may be interested in this discussion: WP:Articles for deletion/Autosadism. -- œ^™ 20:41, 15 May 2010 (UTC)

Thanks, I've added my two cents. Polyamorph (talk) 21:16, 15 May 2010 (UTC)

Repetitive Self-Harm and Self-Stimulating Behaviors

The topic of repetitive self-stimulating behavior that results in self-injury but is predominantly for self-stimulation should be clearly separated, but also warrants its own heading. This concept is mentioned several times in this article. I hesitated to edit the references to mentally retarded individuals in those contexts, since the references appeared well cited and individuals with MR engage in nonsuicidal self injury of other types also. However, the topic of repetitive self-stimulation in the self-injury context is an essential topic and I believe it should be covered in this article (at least briefly, possibly with redirection to the specific reference populations) but the motivation is distinct (i.e., head banging by autistic individuals). This should be carefully addressed, as it is confusing when this category of behavior is included in the other contexts given the importance of motivational factors in self-injury. CatV71.09 (talk) 16:20, 15 June 2010 (UTC)

Vandalism?

Hi, I wouldn't have made this revert on the basis of vandalism. The article is entitled Self harm so I think the user was just changing the word for consistency purposes. Is there any reason why we must use the term "Self injury" in this instance? If not I think the term "self harm" is preferable. Unless I've missed something I don't think it was deliberate vandalism. Best regards Polyamorph (talk) 07:25, 26 October 2010 (UTC)

sorry i must have used the wrong button. (I was going for a AGF thing) The proposal in the DSM-5 is for Non-Suicidal Self Injury (NSSI) not no suicidal self harm. dsm v site As far as i can tell the APA has rejected the term self harm. cheers --Guerillero | My Talk 02:25, 27 October 2010 (UTC)

thought that might have been the case, the revert is fine but a shame about the edit summary messed up. cheers Polyamorph (talk) 08:36, 27 October 2010 (UTC)

It turns out the user who made that edit has been blocked for sockpuppetry after many similar instances all over medical articles, just goes to show twinkle got it right! Polyamorph (talk) 21:08, 9 November 2010 (UTC)

Actually, no. Their edits were all good faith, not vandalism, but poorly worded and cited. Anthony (talk) 09:17, 10 November 2010 (UTC)

They appear to be good faith but it's pretty clear (to me) and apparently to the admin who blocked their numerous sockpuppet accounts that they are not. Benefit of the doubt and WP:AFG is all very well but when there are 5 or 6 sock puppets making the same, seemingly harmless yet innacurate changes to numerous articles whilst ignoring multiple messages from other users, then sometimes maybe its then that you have to actually trust your instincts instead. Polyamorph (talk) 09:39, 10 November 2010 (UTC)

Yes. I actually asked the admin to block the IP address, because it was getting pretty tiresome. But, for the record (I'm the person who undid most of their edits), most contributions were not inaccurate, just poorly expressed and poorly cited. Anthony (talk) 11:07, 10 November 2010 (UTC)

Ok, fair enough, I agree they weren't obvious vandalism. Still you have to wonder why they felt they needed so many user accounts to make such edits. I just can't bring myself to entirely AGF. But anyway, cheers Polyamorph (talk) 11:51, 10 November 2010 (UTC)

Agreed. Odd. Anthony (talk) 11:54, 10 November 2010 (UTC)

In popular culture section removed

I have removed the following from the article. This is inline with previous discussions here, here and here.

• In HBO's series, The Sopranos, multiple characters engaged in self-mutiliation:
  • In The Sopranos episode, "Mergers and Acqusitions", Valentina La Paz reports, in disgust, to Tony Soprano that in lieu of having conventional sexual relations, Soprano family mob captain, Ralph Cifaretto, asked her to scrape a cheese grater across his back and pour hot candle wax on his testicles.
  • Over the course of several episodes ("Mr. Ruggerio's Neighborhood", "University", "He Is Risen", and "Pine Barrens"), Caitlin Rucker - Meadow Soprano's roommate at Columbia University - worried Meadow and their dormitory resident assistant, Noah Tannenbaum, by pulling out her own hair and engaging in other obsessive-compulsive behaviors and attitudes. Additionally, Caitlin also stopped taking her medication, indulged in drinking alcohol early in the day, taking Ecstasy, and (under the influence of Ecstasy), engaged in promiscuous sex (offscreen) with a stranger at a fraternity party.
  • The Sopranos episode, "Boca", reveals that Ally Vandermeed, a high school and grade school friend of Meadow Soprano, is having a sexual relationship with the girls' high school soccer coach, Don Hauser. The relationship causes Ally to become anti-social and withdrawn from schoolwork and Meadow. Ally practices cutting and, ultimately, tries to kill herself by slicing her wrists after the coach takes another job elsewhere, but her friends find her and she survives.

Polyamorph (talk) 13:52, 8 November 2010 (UTC)

I agree on the removal of that section per the discussions above--Guerillero | My Talk 13:54, 8 November 2010 (UTC)

Yes we need refs for this sort of content. Right now it looks like little more than original research. Doc James (talk · contribs · email) 13:58, 8 November 2010 (UTC)

Not only that but since SH has gotten "cool" pop culture talks about SH a lot. This is the perfect place for soap boxing, fam boys, and example creep. Its against policy if I remember correctly too. (I forget the accual link and I'm in school, writing a paper on PF Skinner so i don't have the time to go poke arround for it)--Guerillero | My Talk 14:10, 8 November 2010 (UTC)

Absolutely. I am, however, not completely opposed to including famous instances of self harm though, the Richey James NME incident for example is very notable and other instances where self harm has been popularised (wrong word I know but hopefully you get my meaning) in modern media would be noteworthy, I think. But such sections have a tendency to get out of hand. Polyamorph (talk) 14:13, 8 November 2010 (UTC)

I made that entry in good faith and was unaware that obvious cases of self-harm in popular culture were not eligible for inclusion in that article. This work was NOT original research, as a viewing of the specific episodes cited would confirm (although, admittedly, the Tony Soprano case was purposefully left vague by the show's creators). Moreover, I certainly did NOT mean to violate the 3-revert rule! I was working on several pages at once and didn't realize that someone had purposely removed my entries-in-progress - multiple times! Rather, I was getting annoyed with myself, as I (incorrectly) assumed that I had inadvertently turned away from the page-in-progress, repeatedly, before having had a chance to save it. Mea culpa!Froid 15:25, 8 November 2010 (UTC)

No worries this sort of thing happens to all of us. While yes one can watch this episode is there any third party commentary that discusses it to verify notability? I other words there are hundred of example of self harm in literature why are these ones special. Doc James (talk · contribs · email) 18:50, 8 November 2010 (UTC)

Possible expantions

• Subcultural correlation
  • emo and goth are seen in the wider culture as going hand and hand with SH. The correlation or lack of one should be reported
• History
  • The section ends about 2000
• Society
  • Each mentioned culture should be drawn out into a section

--Guerillero | My Talk 20:50, 10 August 2011 (UTC)

I'm not sure how many studies there have been on the influence of culture on self harm but I think it is possible that there is a correlation. I was also thinking about the body modification aspect and that some cultures use some extreme techniques, such as scarification, which I guess are a form of self harm yet with a secondary purpose. It is, however, already in the hatnote, so I'm not sure how suitable it is to include in the article.Polyamorph (talk) 12:19, 4 September 2011 (UTC)

See Goth_subculture#Self-harm_study for one such claim made about goth subculture (though it was a rather small sample). Mdwh (talk) 21:09, 18 September 2011 (UTC)

Images of self-inflicted injuries

I understand that Wikipedia tries to provide as much information as possible, and of course, to someone who self-harms, the entire text of this article could potentially be triggering (i.e., inspire further self-injury), but does the image of self-inflicted cuts really add enough to the article to outweigh the potential psychological impact? Many people find pictures more viscerally affecting than words, and the image doesn't convey any information that isn't already covered by the text. I see that this issue has been discussed in the past, and as I'm not a frequent contributor to Wikipedia, I won't go so far as to remove the image myself, but I was taken aback by its inclusion. Images of cuts and other injuries can be found at Wound; this page is about a phenomenon that's as psychological as it is physical, and I don't think it's unreasonable to try to avoid unnecessarily harming people who come here for information. 174.60.25.64 (talk) 13:43, 30 October 2010 (UTC)

The image is an example of self-inflicted cuts. It is there purely as an example of what self harm typically looks like for educational purposes. It is not designed to be a trigger and I personally do not see this article or the images included in it as triggering. I think the article deals with the subject in a very professional manner and see no reason to remove the image. Polyamorph (talk) 17:01, 30 October 2010 (UTC)

I agree with Jdrewitt. Wikipedia is also not censored. The article on beer on could argue could trigger drinking in alcoholics. The one on cigarettes smoking in smokers. The one on food eating in obese people / food addicts ( and we have a whole Wikiproject on food ). We must keep in mind that this is an encyclopedia. Doc James (talk · contribs · email) 17:06, 30 October 2010 (UTC)

I'm sure the image isn't intended to be triggering, and I completely agree that it isn't possible (or desirable) to protect against every single possible trigger. But I suggest that self-inflicted cuts are a rather rarer sight than alcohol, cigarettes, or food, and that it doesn't make sense to treat them in quite the same way. No, Wikipedia isn't censored, but I think there's room for discretion; I find that the article on Capital punishment, for example, includes two photographs of executions, but that the thumbnails are actually less graphic than the one in this article. The issue, as I see it, is that the picture poses a real risk of harm to a small but vulnerable portion of the population, while presenting only a slight benefit to other readers. 174.60.25.64 (talk) 03:44, 31 October 2010 (UTC)

But seeing that cigarettes kill 50% of the people who smoke them cigarettes are a bigger concern IMO. They are also the number one leading cause of death in the world. I am still not for banning image of them on Wikipedia however. You could get my support for banning their sale. Doc James (talk · contribs · email) 03:57, 31 October 2010 (UTC)

I'm not interested in banning images of cigarettes on Wikipedia, either, because as far as I know, pictures of cigarettes have next to no bearing on the difficulty of quitting smoking. Images of self-inflicted injuries are known to be triggering; I'd be happy to be corrected if I'm wrong, but I'm not aware of any evidence that images of cigarettes have a comparable effect. 174.60.25.64 (talk) 20:30, 31 October 2010 (UTC)

You mean that tobacco companies have wasted billions of dollars over the years on cigarette advertising that does not work?Doc James (talk · contribs · email) 21:10, 31 October 2010 (UTC)

The image presented in the article is not the most graphic example of self harm that we could show. It does not show someone actually cutting or blood flowing which I agree would be very triggering. Instead It simply shows some moderate scratches, I think it is important to show this image as an example of what self-harm typically looks like. I think it would be preferable to obtain a better quality image at some stage but this image is fine for now. It's not going to be removed because as Doc James points out wikipedia is not censored. Polyamorph (talk) 08:23, 31 October 2010 (UTC)

Actually you have just completely dumbfounded your argument by saying that this (from the capital punishment page) is less graphic than our image of self-harm. There is nothing wrong with our image, if it causes you offence then that is not our problem, the team of editors that have written this article have previously mutually agreed on it's suitability. Polyamorph (talk) 08:33, 31 October 2010 (UTC)

I'm sorry if I wasn't clear: I was referring specifically to the thumbnail which appears as part of the article, not to the full-size image. In the thumbnail of the execution, I have to look fairly closely even to figure out what's going on. The image at the top of the article on self-harm, on the other hand, is perfectly recognizable even in thumbnail form as a picture of an arm with multiple cuts. You're right that the picture could be more graphic; I'm glad it isn't. But since you mention the possibility of eventually replacing it, let me ask, would you be willing to accept a black-and-white diagram of an arm with cuts as a substitute, if one could be obtained? That would illustrate the concept of cutting without the immediacy of a color photograph. 174.60.25.64 (talk) 20:30, 31 October 2010 (UTC)

(OD) Thumbnail? Which one? Doc James (talk · contribs · email) 21:12, 31 October 2010 (UTC)

The OP is referring to the thumbnail on the Capital punishment page of a person being sliced to death. Apparently that is not graphic but our image is!Polyamorph (talk) 07:39, 1 November 2010 (UTC)

Even in the thumbnail on the capital punishment page it is pretty clear to me what is going on in the image to me. When I said we were looking to replace the image I meant a better quality image. The current one is a little blurry and not fantastic resolution. This has been discussed before. But no, I would not accept a tamed down black and white diagram because as I have already stated this image is by no means extreme and I see nothing wrong with including it in the article.Polyamorph (talk) 07:23, 1 November 2010 (UTC)

I think that is the tamest picture of SH that I've ever seen. --Guerillero | My Talk 22:30, 31 October 2010 (UTC)

I agree with Guerillero. Also what is the point of having a diagram when we have a photo of the real thing? Also as mentioned before we do not censor. Peter.C • talk 00:23, 1 November 2010 (UTC)

BTW there is a site called encyclopedia dramatica that allows user contributions. They also have a page on self harm / suicide. Would recommend people who wish to decrease triggers go there and try to improve things. They also have a great deal of hate speech, etc. Not SFW. Doc James (talk · contribs · email) 00:43, 1 November 2010 (UTC)

Thats a worse then sending them off to a pro site... --Guerillero | My Talk 13:07, 2 November 2010 (UTC)

Exactly, there are sites out there that actually intentionally provide triggering images and belittlement of sufferers. This encyclopedia article simply provides information on the disorder in a predominently medical context. The image of self-harm is absolutely necessary to educate readers as to what self-harm looks like. We can't just assume all readers self-harm themselves or know people that have done so. So for the sake of having a complete encyclopedia article we should have an accurate image. Any suggestion that the article causes harm to its readers is absurd and comes from some naive sense that we have a responsibility to protect people from themselves. We might as well propose Suicide at AfD (articles for deletion) lest someone read the article and do themselves in. Polyamorph (talk) 07:53, 1 November 2010 (UTC)

There seems to be a consensus among registered users, so unless anyone wants to discuss the matter further, I'll concede the point and withdraw. I understand that Wikipedia is not censored; I also gather from articles such as Sexual intercourse (and for that matter, Suicide) that judgment is used in selecting images for inclusion in articles. I defer, however, to the judgment of those more familiar with the culture of Wikipedia. 174.60.25.64 (talk) 05:47, 2 November 2010 (UTC)

:I suggest you take time to read WP:TALK and maybe think about removing the personal attacks you have made above. Polyamorph (talk) 22:00, 2 November 2010 (UTC)

I am not the author of the unsigned comments I think you're referring to; see the revision history for that user's IP address. 174.60.25.64 (talk) 02:55, 3 November 2010 (UTC)

Ok, sorry about the mix up. In this case I have removed the comments above which aimed to misrepresent your views and contained personal attacks. Normally we don't remove comments by other users but in this instance I think it is valid to do so. I just want to clarify my use of the term "naive" in my comments above was not meant as an insult, I used it in terms of naivity of wikipedia policy and nothing more. Best regards Polyamorph (talk) 07:27, 3 November 2010 (UTC)

It's triggering. Please take it off. I can't read a single thing on this page without fear. —Preceding unsigned comment added by 64.107.84.160 (talk) 19:38, 30 April 2011 (UTC)

I personally don't find it triggering. At any rate, this is an encyclopedia, censorship does not apply here. This is not really a matter of opinion or consensus. 95.109.102.252 (talk) 15:28, 16 May 2011 (UTC)

This is an encyclopedia article and for completeness it is appropriate to show an image of the article's subject. This article is written in a predominantly medical context and is not designed to "trigger" readers. The image itself is a very moderate example of self harm. The article is designed to provide knowledge on the subject. A useful side effect is that the article could also improve general awareness of the condition. However, I do suggest that any readers who find the article content distressing or triggering in any way to contact a health professional. Polyamorph (talk) 17:27, 16 May 2011 (UTC)

While I agree that, Wikipedia being an encyclopedia, the information presented in the article should not be edited (picture included), I still can't help but feel as if something should be done to prevent triggering. Because while, yes, this is an encyclopedia, people who self-injure could easily find their way here through Google unaware of what they'll see. As an internet website I believe more responsibility is necessary both because of it's far greater accessibility compared to real, tangible encyclopedias as well as Wikipedia's popularity as a universal information source. Would merely adding a disclaimer warning that some of the articles' content may cause triggering at the top of the article itself (leaving empty space between the warning and the article) be too much to ask? Some peoples' safety may literally be at risk because of this article, and with that in mind the fact that this is an encyclopedia comes off as resoundingly unimportant when discussing whether or not it should be modified. — Preceding unsigned comment added by 142.165.170.233 (talk) 10:11, 13 October 2011 (UTC)

On wikipedia we don't add disclaimers, since there is already a general disclaimer at the bottom of every page. I don't see that this article is triggering and I cannot see how anyone's safety is at risk from reading an article about the condition in a predominently medical context. Polyamorph (talk) 10:59, 13 October 2011 (UTC)

illogical distinction

"men more frequently report burning and hitting themselves, whereas women are more likely to report cutting and burning themselves." They can't both report burning themselves more frequently than the other. Noloop (talk) 03:10, 4 September 2011 (UTC)

Hi, I checked and it was written like that in the source "Kerr, P.L., et al. (2010), Nonsuicidal Self-Injury: A Review of Current Research for Family Medicine and Primary Care Physicians, 23, pp. 240–259". However, I have clarified the statement.Polyamorph (talk) 11:11, 4 September 2011 (UTC)

Is it addictive like listening to loud music?

A while ago i read about a study that found that listening to loud music is addictive because of the micro lesions to the eardrum and other parts of the inner ear caused release of endorphin (natural painkiller that feels good and can be addictive), and the brain start getting desensitized needing more and more for the same effect. Is self-harm, or at least some forms of it, addictive in a similar manner? --TiagoTiago (talk) 04:54, 13 November 2011 (UTC)

Please add photo

Hello,

I'm not an expert on anything, and will never edit ten articles, or figure out how to add an image to a page. I just uploaded a photo I took today (automutilation-cigburns.png) to wikicommons to be added to the automutilation page. It is under the category: automutilation.

Thanks in advance Shankus (talk) 22:52, 29 December 2011 (UTC)

Peer review

I have (finally after finding some spare time) been through the peer review comments kindly made by Finetooth. I've addressed all of his comments and made most of the suggested changes, where appropriate. I believe the next step is for the regular editors (or anyone else who fancies it) to check the entire article for coherency and completeness prior to submitting to WP:FAC. Polyamorph (talk) 08:46, 4 September 2011 (UTC)

Ya I think you might consider tossing up a new peer review. That is kind of a crappy article. There are alot of sources that need to be added in various places. And I'm sorry but is there an attempt to write a self help video script here? Functions of self-injury sounds more like an opinion about self injury is being made than an actual explanation of the function of self injury. It's sounds like your telling people that meditation would be healthier and they should learn to communicate better. There's a very little about the actual function of it. I honestly hope that when this was GA certified that was in alot better condition than it currently is.198.45.184.25 (talk) 14:56, 1 November 2012 (UTC)

The beauty of wikipedia is that if you see something that is not right, you can fix it. If you see there are some sources lacking then you can add them. If you think something is skewed to a specific point of view you can change it. So if there is anything specific either be bold and change it yourself or request the change be made here. Polyamorph (talk) 16:08, 1 November 2012 (UTC)

Ya that tirade contained suggestions. There are numerous sources available online from reliable institutions such as the Mayo clinic. Encyclopaedic content must be verifiable. Contains one source and it not clear if that one source covers the whole section. Is a self injurer like a heroin addict? Do they need a bigger dose if they keep on going? No clue because I can't actually verify it with a source. Beyond the numerous online sources there are numerous books written on it. I could hen peck the whole article and point out a number of issues that should be fixed but a reassessment would simply be quicker. I do not know what this page looked like when it was certified but It's certainly not GA quality now. I would be bold but respectfully I have reasons not to.198.45.184.25 (talk) 19:50, 2 November 2012 (UTC)

It's easy to pick holes and say "this article is kind of crappy" but if you're not prepared to do anything about it I don't know how you expect anyone else to. We're all volunteers, all the work that has gone into this article (and that is in itself considerable) has been given for nothing. If you expect people to do work for you then at least make an effort to be a little more specific as to what exactly you have an issue with and how it should be fixed. I wouldn't call an article with 101 references unverifiable. Sure there may be some specific issues in which case point them out to help those who actually want to improve the article, rather than argue specifics over which article class it belongs to - changing it's status isn't going to fix the issues is it? Polyamorph (talk) 20:12, 2 November 2012 (UTC)

Do Not Re-Add Trichotillomania

Trichotillomania is not a self-harming or self-injury disorder and including it on this page is misinformation. Please consult the Trichotillomania Learning Center for more information. — Preceding unsigned comment added by 50.89.183.195 (talk) 02:39, 20 February 2012 (UTC)

It's well-sourced, see e.g. http://www.mentalhealth.org.uk/publications/truth-hurts-report1/ and other citations given in the article. It's clearly a form of self harm and although we don't aim to list all possible methods, it is an important one and has it's own wikipedia article. Polyamorph (talk) 09:04, 20 February 2012 (UTC)

No Secrets Support Organisation

I volunteer for an organisation that provides peer support to people who self harm in the north west of England. Also provided is email and phone support for anyone who does not live close by. The organisation provides training to staff within the health and caring professions around self harm. The organisation is currently applying for charity status and I feel it would be useful to have a link from the self harm page to the No Secrets website: http://nosecrets.moonfruit.com/#

No we do not typically provide these links. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:15, 11 February 2013 (UTC)

SIBIS Link

Hey everyone, I'd like to add a link to the Self-Injurious Behavior Inhibiting System (SIBIS) page under the Treatment section of this article, specifically in the paragraph that talks about developmental disorders. TheAtomicBen and I are working on the APS Wikipedia Initiative and are trying to improve the SIBIS page by referencing it in other articles. Here's the article for those who are interested :http://en.wikipedia.org/wiki/Self-Injurious_Behavior_Inhibiting_System Any thoughts/comments on this? I've never edited Wikipedia before so this is all new to me. Any help would be appreciated. SIBISEditor (talk) 22:25, 11 November 2012 (UTC)

Further reading

This section has grown out of control, so I have moved it out of the article into this talk page. Please see Wikipedia:Further reading and put only entries that are topical, reliable and balanced, and please, keep the section limited in size. "Wikipedia is not a catalogue of all existing works." Please, if you add an entry back into the article, motivate why. Thank you! Lova Falk talk 09:44, 28 November 2012 (UTC)

• Adler, Patricia and Peter Adler. (2011), The Tender Cut: Inside the Hidden World of Self-Injury, New York University Press, ISBN 0-8147-0507-3

• Bogdashina, O. (2003), Sensory Perceptual Issues in Autism and Asperger Syndrome, Different Sensory Experiences, Different Perceptual Worlds, Jessica Kingsley, ISBN 978-1-84310-166-6

• Farber, S. (2002), When the Body Is the Target: Self-Harm, Pain, and Traumatic Attachments, Jason Aronson Inc, ISBN 978-0-7657-0371-2

• Favazza, A. R. (1996), Bodies Under Siege: Self-Mutilation and Body Modification in Culture and Psychiatry, Johns Hopkins University Press, ISBN 978-0-8018-5300-5

• Griffin, J. & Tyrrell, I. (2000), The Shackled Brain: How to release locked in patterns of psychological trauma, Organising Idea Monograph: 5, European Therapy Studies Institute, ISBN 1-899398-11-2{{citation}}: CS1 maint: multiple names: authors list (link)

• Hawton, K. and Rodham, K. (2006), By Their Own Young Hand: Deliberate Self-harm and Suicidal Ideas in Adolescents, Jessica Kingsley, ISBN 978-1-84310-230-4{{citation}}: CS1 maint: multiple names: authors list (link)

• Kaminski, M. M. (2004), Games Prisoners Play, Princeton University Press, ISBN 0-691-11721-7

• Kern, J. (2007), Scars That Wound: Scars That Heal, Standard Publishing, ISBN 978-0-7847-2104-9

• Levenkron, S. (1998), Cutting: Understanding and Overcoming Self-Mutilation, W. W. Norton and Company., ISBN 978-0-393-02741-9

• McVey-Noble, M.; Khemlani-Patel, S.;Neziroglu, F (2006), When Your Child is Cutting: A Parent's Guide to Helping Children Overcome Self Injury, California: New Harbinger, ISBN 978-1-57224-437-5{{citation}}: CS1 maint: multiple names: authors list (link)

• Miller, D. (1994), Women Who Hurt Themselves, Basic Books, ISBN 978-0-465-09219-2

• Plante, L. G. (2007), Bleeding to Ease the Pain: cutting. self-injury, and the adolescent search for self, Praeger Publishers, ISBN 978-0-275-99062-6

• Smith, C. (2006), Cutting it Out: a journey through psychotherapy and self-harm, Jessica Kingsley Publishers, ISBN 978-1-84310-266-3

• Strong, M. (1998), A Bright Red Scream: Self-Mutilation and the Language of Pain, Viking Press, ISBN 978-0-670-87781-2

• Whittenhall, E. (2006), Cutting: Self-Injury and Emotional Pain, InterVarsity Press, ISBN 978-0-8308-4990-1

• Beauchaine, T. P., Gatzke-Kopp, L., & Mead, H. K. (2007). Polyvagal theory and developmental psychopathology: Emotion dysregulation and conduct problems from preschool to adolescence. Biological Psychology, 74, 174-184.
• Beauchaine, T. P., Katkin, E. S., Strassberg, Z., & Snarr, J. (2001). Disinhibitory psychopathology in male adolescents: Discriminating conduct disorder from attention-deficit/hyperactivity disorder through concurrent assessment of multiple autonomic states. Journal of Abnormal Psychology, 110, 610-624.
• Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory. Psychological Bulletin, 135, 495-510.
• Crowell, S. E., Beauchaine, T. P., McCauley, E., Smith, C, Stevens, A. L., & Sylvers, P. D. (2005). Psychological, physiological, and serotonergic correlates of parasuicidal behavior among adolescent girls. Development and Psychopathology, 17, 1105-1127.
• Crowell, S. E., Beauchaine, T. P., McCauley, E., Smith, C, Vasilev, C, & Stevens, A. L. (2008). Parent-child interactions, peripheral serotonin, and intentional self-injury in adolescents. Journal of Consulting & Clinical Psychology, 76, 15-21.
• Hooley, J. M., Ho, D. T., Slater, J., & Lockshin, A. (2010). Pain perception and nonsuicidal selfinjury: A laboratory investigation. Personality Disorders: Theory, Research, and Treatment, 1, 170–179. doi:10.1037/a0020106
• Kross, E., Berman, M., Mischel, W., Smith, E. E., & Wager, T. (2011). Social rejection shares somatosensory representations with physical pain. Proceedings of the National Academy of Sciences, 108(15), 6270-6275.
• Kuo, J. R., & Linehan, M. M. (2009). Disentangling emotion processes in borderline personality disorder: physiological and self-reported assessment of biological vulnerability, baseline intensity, and reactivity to emotionally evocative stimuli. Journal of Abnormal Psychology, 118.
• Linehan, M. M. (1993). Cognitive-treatment of borderline personality disorder. New York: Guilford Press.
• Nixon, M. K., Cloutier, P. F., & Aggarwal, S. (2002). Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 1333-1341.
• Nock, M. K. (2009). Why do People Hurt Themselves? New Insights Into the Nature and Functions of Self-Injury. Current Directions in Psychological Science, 18(2), 78-83. doi:10.1111/j.1467-8721.2009.01613.x
• Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339-363. doi:10.1146/annurev. clinpsy.121208.131258
• Nock, M. K., Joiner, T. E. Jr., Gordon, K. H., Lloyd-Richardson, E., & Prinstein, M. J. (2006). Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144, 65–72.
• Nock, M. K., & Mendes, W. B. (2008). Physiological arousal, distress tolerance, and social problem-solving deficits among adolescent self-injurers. Journal of Consulting and Clinical Psychology, 76(1), 28-38. doi:10.1037/0022-006X.76.1.28
• Nock, M. K., & Prinstein, M. J. (2004) A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72, 885–890.
• Nock, M. K., & Prinstein, M. J. (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology, 114(1), 140-146. doi:10.1037/0021-843X.114.1.140
• Porges, S. W. (2001). The polyvagal theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42, 123-146.
• Rodham, K., Hawton, K., & Evans, E. (2004). Reasons for deliberate self-harm: Comparison of self-poisoners and self-cutters in a community sample of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 80-87.
• Vasilev, C. A., Crowell, S. E., Beauchaine, T. P., Mead, H. K., & Gatzke-Kopp, L. M. (2009). Correspondence between physiological and self-report measures of emotion dysregulation: A longitudinal investigation of youth with and without psychopathology. Journal of Child Psychology and Psychiatry, 50, 1357-1364.
• Zlotnick, C, Donaldson, D., Spirito, A., & Pearlstein, T. (1997). Affect regulation and suicide attempts in adolescent inpatients. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 793-798.

Primary research

This article is getting filled full of primary research again. I have removed a bunch. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:56, 21 January 2013 (UTC)

Helpful Video

heres a helpful vid you should add to external links or somewhere: http://www.youtube.com/watch?v=l8ovOA7VhFo — Preceding unsigned comment added by 123.255.41.1 (talk) 12:15, 26 January 2013 (UTC)

Thanks but it doesn't seem to be a suitable external link for a wikipedia article. Polyamorph (talk) 14:31, 1 February 2013 (UTC)

Self-harm in animals

Canines have been known to deliberately gnaw a limb off, in order to escape a trap. Would this class as "self-harm in animals", and can it be added? — Preceding unsigned comment added by 151.230.92.242 (talk) 11:49, 21 May 2013 (UTC)

Article contradicts itself in same paragraph

The "Classification" section reads: "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." ... then just a few sentences later, it reads "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 an attempt to communicate distress". How is wanting to communicate distress NOT attention seeking? I really do not see how it can be anything but seeking attention from others (in order to get across how depressed they are to others if they have no other way of explaining just HOW depressed they are). And of course most who do so will say they don't do it for attention, but that in itself is almost attention seeking. Them feeling shame or embarrassed about it DOES NOT mean that they didn't do it to get the attention of others, as people's emotions are not static. yonnie (talk) 19:28, 18 August 2013 (UTC)

Self Harm Self Help Support Site Link

I myself am a self harmer and have been self harming since I was 10 (I am now 19) but have been self harm free for just over 4 months. I think that it would benefit other self harmers who are in recovery or who want to start recovery, for there to be a link to www.recoveryourlife.com which is as the title says a self help site in the form of a forum with many ways to distract yourself from urges to self harm, and many people who no what you are going through. Stormy Nights (talk) 13:42, 27 December 2013 (UTC)

People can find these sorts of sites through google. We have a policy of not linking to self help sites as there are many. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:01, 27 December 2013 (UTC)

Okay. I am sorry I didnt know. Stormy Nights (talk) 15:13, 27 December 2013 (UTC)

Messy

I realize that to some degree this article reflects the degree of controversy around motivation and the ever-changing realm of associated disorders, but frankly, the lack of clearly delineating the competing ideas around the actual behavior just makes it a confusing muddle. There's the camp of "it's all attention seeking," and there's the camp of "no, most of it probably isn't," and there's the camp of "culture defines the boundaries here anyway," there's the shifting demographic associations, there are huge changes going on in how to describe this and there are still ways of thinking that filter around from the 90's and before. That's the state of things, but please try to be clearer that all of those competing ideas and shifts in category do exist, because frankly, this thing contradicts itself in a million places. I know why, but that's just a confusing muddle for the layperson, and likely to provide fodder for _whichever_ way anybody prefers to already think of it.

I also frankly have to flat question why Munchausen's is even mentioned, as it's a completely different set of stuff even by flat DSM standards and has been for a long time. I mean, certainly Munchausen's involves self-injury, but that's not the same thing as some teenager taking a razor to their arms. People who cut or chew or burn themselves repeatedly are not generally under any consideration for a diagnosis of Munchausen's, unless there are a lot of other things going on there. It's a really strange thing to include, while so carefully weeding so many other things. 24.7.160.26 (talk) 00:56, 26 February 2014 (UTC)

Promotes Generalization

Nonsuicidal self-injury or NSSI is indeed relatively common in the adolescent years of life. It is defined as directly harming your body by either repeatedly cutting or burning yourself but, without the intent of dying. Reports by clinicians, health professionals and teachers have noted a dramatic increase in NSSI in the recent years of study (Hoeksema 2011, p. 214). Individuals that engage in NSSI are at an increased risk for attempts at suicide. In the wikipedia article "Self-harm" [9], provides a substantial amount of knowledge on self-injury, especially the predicted causes. But, a nice addition to the information already there is to include another subheading under the 'Causes' heading specifically to the theories of NSSI functioning as of regulating emotion and influencing the social environment. Fore, people who engage in NSSI often report feeling the pain and seeing the richness of color in the blood alleviates their tension. As well, it draws support and sympathy from others (Hoeksema 2011 , p. 214) . This should be added because the information provided in the "self harm" article alone generalizes and categorizes this deliberate act of self injury to four predisposed causes of mental illnesses, psychological factors, genetics and drugs and alcohol. Directly excluding the possibility of eating disorders and personal satisfaction as a factor of causation, this separates the NSSI from its global definition of having no intent to be suicidal. Instead, it creates labels and brings on the assumption that the reason why someone is hurting themselves has to deal with the disapproval from others, your brain functioning, genetic factors and the abuse of substances; instead of an individual's way of effectively coping. As mentioned, this method of pain has been reported to calm a distressed individual. With longitudinal data lacking significantly in this subject, the current four causes are too biased to provide any basis of validity. All in all, incorporating another causes subsection (3.5 Personal Satisfaction) would align all possibilities together and provide more evidence for research on triggers for self injury, as it is definitely needed.

Gatorbait18 (talk) 00:03, 20 April 2014 (UTC)

New Edits for NSSI

I have important new and validated information about the new diagnosis for NSSI. My information has been deleted due to it not being encyclopedic. I have included the new edits I believe are important for the page. Please tell me more specifically which aspects stray from the encyclopedic format so that I can rework the information to fit the formatting of Wikipedia. Lexcurhan (talk) 02:28, 22 April 2014‎ (UTC)

Awareness

To Write Love On Her Arms is an organization that focuses on raising awareness about the dangers of self-harm, as well as about possible treatment options for those seeking help for themselves or others. In addition, the organization participates in special days where they encourage people to write the word “LOVE” in pen on their arms to show support for those who suffer from NSSI. The organization also organizes fundraising events, such as a 5K, in order to increase awareness.

Non-Suicidal Self Inury (NSSI) (Intended Entry)

Recently, Non-Suicidal 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, other forms of addiction). Just like these other disorders, once the self-harming behaviors cross a certain threshold, it then becomes classified as a mental health disorder.

DSM-V Criteria for NSSI

5+ Days of Intentional Self Inflicted Damage to the body Self-injury is associated with one of the following criteria: (a) Interpersonal difficulty or negative feelings/thoughts (depression, anxiety), (b) Premeditation, (c) Ruminating on self injury (without suicidal intent). Socially sanctioned behaviors (piercing body parts, tattoos, cultural rites of passage) are not included in the NSSI diagnosis. Also, people who have expressed suicidal feelings/thoughts/behaviors/intentions within the past 24 months are excluded from the diagnosis.

Examples of NSSI

Moderate to severe NSSI include: cutting or carving skin, scraping, burning skin, rubbing skin to draw blood, self-tattooing, and others. Minor NSSI include: picking at a wound, biting self, hitting self, inserting objects under skin or nails, pulling out one’s own hair, and picking skin to draw blood.

Recent Findings about NSSI

Studies have found that NSSI is most commonly comorbid with developmental disabilities, Borderline Personality Disorder, and Eating Disorders. The causes for NSSI are very similar to those of self-harm, but current research is still investigating the underlying causes for NSSI. Treatment for NSSI is the same as described in the treatment section for self-harm: Cognitive Behavioral Therapy, antidepressants, family or group therapy, as well as differing combinations of those treatments.

21 April 2014

There are a bunch of issues includeing

1. Formatting is no in line with the manual of style. To many caps
2. Refs are not formatted
3. Some of the refs are not suitable. Please read WP:MEDRS

Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:07, 22 April 2014 (UTC)

Lexcurhan, as you may have already seen, I explained on my talk page the problems with your addition.

And remember to sign your username at the end of the comments you make on Wikipedia talk pages. All you have to do to sign your username is simply type four tildes (~), like this: ~~~~. I signed your comment for you above. Flyer22 (talk) 07:11, 22 April 2014 (UTC)

Digital Self-harm

I wanted to add information about digital self harm especially in light of the (IMO) under reported case about Hannah Smith in the UK who's suicide provoked a major outcry against Ask.fm but in fact it turned out 98% of the hateful messages were from herself.

Is this the correct page to the add the info to or should it get it's own one? The issue appears to sit half way between Self-harm and Cyberbulling but I'm not sure where's best Deku-shrub (talk) 01:49, 27 April 2014 (UTC)

We sort of need better sources. We tend not to use popular press for medical content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:06, 27 April 2014 (UTC)

This is not an "issue" at all and doesn't deserve a page at all. It's just overapplication of a term. (Incidentally, all self-harm is digital, unless one bites oneself--then it is dental...) 11:46, 27 April 2014 (UTC) — Preceding unsigned comment added by 83.28.39.205 (talk) SineBot you dolt, I HAVE signed myself.

The sources are weak, but not non-existent, I accept this. Starting with a good name is certainly important, I've seen 'online self-harm' as a synonym. Happy to write the page with disclaimers about it not being an accepted psychological term. Thinking about the issue some more, I think it might find it's place in attention seeking, I don't know really. Looking for the best page to start writing up the info I have. I'll be honest, there's probably enough press coverage to start Hannah Smith (dead teenager) of some kind, but I would find creating such an article personally in bad taste.

The Hannah Smith case is notable due to:

• The volume of (UK, but also pan-european) press coverage focused on Cyberbullying
• The press and government condemnation of the inaction of Ask.fm
• The implementation of advertising blocking, some web blocking and calls to implement web blocking in response to the perceived inaction of Ask.fm.
• The under reported element towards the end of the case when it was revealed most messages were sent to by the girl to herself, and the narrative of ubiquitous cyber bullies using a platform run by uncaring profiteers quietly fell apart.

I'm interested in adding information about this area due to my amateur psychology interest and significant contributions to article Web blocking in the United Kingdom where I'm trying to capture increasingly populist calls for web blocking by citing cases such as this.

Deku-shrub (talk) 23:37, 27 April 2014 (UTC)

Not really notable here though. We do not typically use popular press for medical content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:18, 28 April 2014 (UTC)

Assessment and Diagnosis Sandbox Edits for Non Suicidal Self Injury

Hello all, I have made changes in my Sandbox about this topic focusing on evidence-based assessment and diagnosis. It would be great if people would look at it and leave comments on my talk page before I post it on the article.

The sandbox link can be found here (https://en.wikipedia.org/wiki/User:Akerhoulas/sandbox).

I appreciate it! YenLingChen (talk) 20:11, 4 November 2014 (UTC)

see Talk:Autism_spectrum#Assessment_and_Diagnosis_Sandbox_Edits_for_Autism_Spectrum_Disorder and see User_talk:YenLingChen and Wikipedia_talk:WikiProject_Medicine#slew_of_student_postings Jytdog (talk) 13:13, 5 November 2014 (UTC)

The current image is not representative

Why is the current image so tame? It is not representative of self-harm. Preferably, most representatively, the image should depict an arm (or rather a thigh) with old, white scars of varying severity, a couple of recent ones, and a couple of freshly-made wounds of varying severity, from scratches (as in the current picture) to cuts exposing the fat tissue (and possibly cutting through it; I am not sure of incidence of this depth), together with an image of the amount and flow of blood from them. — Preceding unsigned comment added by 83.6.187.190 (talk) 08:13, 23 April 2014 (UTC) Fuck off, SineBot, I intentionally don't sign my comments. This impinges on the principle of anonymity.

Indeed, such an image would illustrate two points at the same time. Currently, the very first line of the article says "this article focuses on repetitive self-harm". There is no indication of that in the current picture at all; it just depicts the result of an, apparently, first attempt(s). And then, the varying severity of the wounds would illustrate the connection between commission of s.h. and intensity of emotions one experiences while committing it, which again varies as well.

If you have a better one we can discuss. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:38, 23 April 2014 (UTC)

That's quite a peculiar point of view with respect to discussing article improvement suggestions. — Preceding unsigned comment added by 83.6.189.85 (talk) 12:22, 23 April 2014 (UTC) (Also, it is not as though pictures of s.h. are a rare commodity--any Wikipedian can provide one, although of course it would take a couple of months--well, perhaps up to a year or two--until the scars whiten up completely to the degree which I posited.) (Also, again, fuck off, SineBot.) — Preceding unsigned comment added by 83.6.189.85 (talk • contribs)

There's no need for that. I have layered scars, both old enough to be white and more recent ones. I can take a picture of my arm to contribute. Ketsuekigata (talk) 12:19, 17 September 2014 (UTC)

By all means, if you can provide a better image please feel free to do so. The preceeding comments by the anonymous editor are, however, not appropriate. Polyamorph (talk) 12:32, 17 September 2014 (UTC)

Agreed. Ketsuekigata (talk) 08:12, 18 September 2014 (UTC)

'Not appropriate'? Why's that? Because I provided numerous specific suggestions regarding what an illustration of self-harm should provide to be most informative and most representative of the phenomenon? — Preceding unsigned comment added by 79.191.218.74 (talk • contribs)

IP, as for signing your username, that is required, which why the bot usually signs for you when you don't. If you don't want your IP showing up, then get a registered Wikipedia account if you don't have one already. Flyer22 (talk) 00:53, 18 May 2015 (UTC)

Registered user, if signing were truly a pillar of Wikipedia, it would have been implemented from day one and not added as an afterthought via a bot. IPs are available in the edit history and readding them into the talk page body is redundant and arbitrary. ---- (there, I signed myself with four hyphens.) — Preceding unsigned comment added by 178.43.11.98 (talk • contribs)

I see a lot of cases of self harm and plenty of them like this. Doc James (talk · contribs · email) 11:49, 24 May 2015 (UTC)

'Like this' is weasel words. Like how? State your criticism explicitly or not at all, rather than giving yourself room to deny any accusations of insult with 'I meant nothing bad'. — Preceding unsigned comment added by 79.191.218.74 (talk • contribs)

To be perfectly clear I have seen many cases of self harm that look very much like this. Thus I have no problems with this image. Doc James (talk · contribs · email) 10:11, 25 May 2015 (UTC)

This is not the place to discuss signatures or opinions thereof. WP:NOTFORUM
The following discussion has been closed. Please do not modify it.
Signed for you again, IP. Signing comments is not redundant and arbitrary; editors have the right to know who made what comment and shouldn't have to go digging in the edit history to see who made the comment. Removing the signatures is arbitrary, since you have no "IP privacy" when you comment on Wikipedia as an IP. And stating that "if signing were truly a pillar of Wikipedia, it would have been implemented from day one" is flawed logic. A lot of things about Wikipedia have changed since day one, and that those things didn't exist from day one doesn't mean that they are not important; I stated nothing about "pillars." The WP:Pillars are a different matter. But when was signing a username never important on Wikipedia? Flyer22 (talk) 12:01, 24 May 2015 (UTC) >Signing comments is not redundant It literally is. >Signing comments is not arbitrary Arbitrarily says you. >you have no "IP privacy" when you comment on Wikipedia as an IP Yes, that's what I said in my previous comment: the IPs are available anyway. I'm pretty sure that no rule requires signing, anyway. It's just a working recommendation. True collaboration only requires sources, data, to be attributable to particular people; WP:V. There is no reason for people *providing* those data to be personally identifiable as well at all. ∿∿∿∿ — Preceding unsigned comment added by 178.43.11.98 (talk) 15:18, 24 May 2015 (UTC) "Literally," huh? Signing your comments is not redundant because it is literally a new signature (time stamp) each time, letting us know who made the comment and when. On highly active talk pages, it's not too easy to check the edit history to see who made the comment; a person has to scour pages of the edit history just to see who commented; and that is a pain. Furthermore, WP:Newbies usually don't know to check the edit history to see who commented. In other cases, a comment is months or years old, and a person has to scour the edit history just to pinpoint who commented; again, a pain. You act like editors are not supposed to know who commented when they collaborate; they are supposed to know that since talk page discussions can easily become confusing if editors do not know if they are talking to the same person or a different person. There is also the factor of WP:Disruptive editors, and pinpointing who made a comment in those cases is obviously needed when it comes to stopping that disruption (the disruptive account is usually WP:Blocked and/or the article is WP:Semi-protected; talk pages are rarely WP:Semi-protected). That is true collaboration, not talking to some "ghost." No rule requires signing? There is: WP:Talk page guidelines#Good practices for all talk pages used for collaboration. And see that it points to WP:Signatures. One can state that these are guidelines and that policies hold more weight, but a Wikipedia guideline is still one of the rules, as made clear at WP:Policies and guidelines. And since you have no "IP privacy" when commenting as an IP, I don't see why you should be stating, "Fuck off, SineBot, I intentionally don't sign my comments. This impinges on the principle of anonymity." or why you are refusing to sign your posts unless it's to make tracking who made the comments (your comments) challenging. Flyer22 (talk) 22:07, 24 May 2015 (UTC) Signing is literally redundant because the data on the IP and time associated with the edit take twice the amount of space in the database they need to. As for your 'looking up edit history is a pain'--arguably. But I don't see why it should be needed. We're here to edit content, not to discuss each other's individual (lack of) merits (in other words, anonymity only causes confusion in discussion when something else than content that's being discussed). Banning happens rarely, and if anything, then complete anonymity makes people less argumentative and disruptive, because there is less reason for them to become emotionally engaged in defending their positions (for instance, protecting their reputation as editors). This whole discussion would have gone no worse if you and everyone else had been anonymous like me. Though, you know what, you've convinced me. I shall sign this post. ~~~~ — Preceding unsigned comment added by 83.24.116.123 (talk • contribs) IP, you won't be convincing me that signing our comments is redundant, just like I won't be convincing you that it isn't. Yes, editors should know who made the comments; I explained why above, and I am right on that because I've seen it for years. Not knowing who made a comment absolutely causes confusion, including when the article content is the only thing being discussed. The other part of the collaboration bit is that editors might need to get in contact with one another on their user talk pages; after all, these talk pages don't exist so that editors can socialize about everyday life (though such socializing happens at user talk pages); these talk pages exist to directly communicate with editors, whether it's because the article might not be on one or more of the editors WP:Watchlists, because they want to discuss other collaborations with the editors, alert the editors to certain matters, warn editors about their disruptive editing, or something else. Also, I spoke nothing of WP:Banning, and WP:Banning is different than WP:Blocking. WP:Banning IPs does not happen, but WP:Blocking them happens very often. And WP:Signatures is clear about what will happen in the case of people being disruptive when it comes to signing their posts. You didn't sign your latest post, of course; EvergreenFir did that. Flyer22 (talk) 16:30, 25 May 2015 (UTC) You say 'you won't be convincing me that signing our comments is redundant'. Obviously. That your definition of redundancy has nothing to do with the databasal sense, and instead refers to, I'm not even sure what, is obvious. One could even say that it is redundant to even mention it. As for whether I signed my post, again you seem to have an odd definition of signing if it refers to something else than typing four tildes. Speaking of definitions, it is also remarkable to hear that *not saying something*, *withholding something*, such as one's identity, being self-effacing, can be disruptive. No, editors don't need to know each other's identity except for social chitchat as you yourself admitted. If an editor wants to benefit from other editors alerting them to things such as article developments, then he definitely *might* divulge his username (I'm not objecting to this), but he obviously doesn't have to. Forcing him to for this purpose would be like forcing people to expose their postal addresses so to allow others to send them parcels. It's clearly absurd. Let me guess, Flyer22, you are an administrator. ~~~~ — Preceding unsigned comment added by 83.9.252.190 (talk • contribs) IP, because the assertion that signing our posts is redundant and useless makes no sense to me, you are twisting some of my words, we won't be changing each other's minds on this matter, and this discussion is off-topic, I'll end this discussion with you by stating that I agree to disagree. And, no, I am not a WP:Administrator. Flyer22 (talk) 09:42, 26 May 2015 (UTC) And as for signing your username, you seem aware that displaying a wiki code for that -- this: ~~~~ -- is not singing your username. And if you do consider that signing your username, you are wrong. I have nothing else to state to you. Flyer22 (talk) 09:48, 26 May 2015 (UTC) Sorry to hurt your WP:Ego, but I am not discussing with *you*. This is precisely the kind of misconception that forcing people to sign themselves perpetuates by making them attached to their identities. I am stating my opinions for every single reader of this talk page; your person is irrelevant here. I am concerned with improving the encyclopaedia, just like an hour ago, when I stressed on this page that the current photo is fucking harmful and misleading because it gives the readers a false, tame picture of typical severity of self-harm as shallow scratches as opposed to, frequently, deep cuts requiring stitches. This comment has since been removed by another editor. ~~~~ — Preceding unsigned comment added by 83.9.252.190 (talk • contribs) — Preceding unasked-for comment added by AnomieBOT (talk • contribs) I don't know why you are resurrecting a year old post but your original comments regarding a wikipedian self harming in order to provide a photo for wikipedia was inappropriate by anyones standards. Your language is also inappropriate. As has been said all along if you can find a better picture then provide one. If you can't contribute constructively then perhaps you shouldn't be here. Polyamorph (talk) 12:14, 26 May 2015 (UTC) Inappropriate is omitting the fucking apostrophe in 'anyone's' and the fucking hyphen in 'self-harm'. Very well; I shall know better than to suggest how a picture of a tree... or a bird... or a flowchart... or self-harm... could be improved. (From which it all started, and at which it should all have ended, if not for the nosy nuisance that is SineBot.) Also it is curios how you construed my comment on how easy it is to procure a good photo as a suggestion that editors should self-harm. ~~~~ Also, as for 'why am I reviving'. Obviously, the time between the comment and reply is irrelevant as long as the reply is relevant and informative. I have always been perplexed by people's arbitrary opposition to reviving old content. I have no idea where it first came from, nor how it became a thing. What should one rather do? Create a new thread/section, thus fragmenting the database in terms of grouping of content? (Not to mention that, as you noticed, it was Flyer22, not me, who revived in 2015 a thread from 2014.) ~~~~ — Preceding unsigned comment added by 83.9.252.190 (talk • contribs) That would have been clear had you timestamped your posts, which is the purpose of the signbot. It is clear that you are not here to improve the article but to be a nuisance and to swear at us. Polyamorph (talk) 21:06, 26 May 2015 (UTC) If signing had anything to do at all with timestamps, there would be no separate three tilde syntax for untimestamped signing. Clearly, signing without timestamping is a perfectly fine thing if the developers have thought about it. (Not to mention that timing your posts is clearly not important if policy on doing it varies even from signing bot to signing bot--SineBot does it (or at least used to), AnomieBOT, as you can see, does not.) Also, how kind of you to consider SineBot one of 'you' at whom I supposedly swear. For SineBot was literally the only 'person' on this talk page that I used an expressive word towards. ~~~~ — Preceding unsigned comment added by 83.24.117.21 (talk • contribs) Oh, and also regarding signatures. I find it quite funny what while comments of both signing bots use a smaller font, the signatures of both proponents of signing in this section are coloured and bolded. I have yet to see an editor with a small, unassuming, non-disruptive signature that doesn't draw attention to itself, like, oh, let me come up with an example, Username ✉ ✎ (the choice of symbols might not yet be perfect). ~~~~

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"most often"

By definition self harm does not involve a wish to die. It is a risk for suicide though. Doc James (talk · contribs · email) 16:26, 22 May 2016 (UTC)

I'll go with that. It was just that there are some sources which do say, usually not. It is a complex issue. But looking into the literature more, most reliable sources say self harm is not a suicide attempt. It was a bold inclusion, no revert. Thanks for explaining here.Charlotte135 (talk) 20:46, 22 May 2016 (UTC)

Removed here [10] as well.Charlotte135 (talk) 20:49, 22 May 2016 (UTC)

Image question

A new image was added a bit ago. To my eye it looks more like an attempted suicide than DSH due to the location of the cuts on the throat. Does anyone else have any opinions about this picture? --Guerillero | Parlez Moi 02:52, 3 June 2016 (UTC)

I didn't check to see when it was added, but, as you know, I reverted an IP's unexplained removal of the image. Feel free to revert me on that. I don't feel strongly one way or the other about the image, but I don't see it as needed or as improving the article. Flyer22 Reborn (talk) 03:47, 3 June 2016 (UTC)

Yes looks like a suicide attempt and not self harm Doc James (talk · contribs · email) 05:41, 3 June 2016 (UTC)