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NU-664C-02-23PCS3 FamilyPsychiatric Ment.Hlth I

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  4. Week 3: Stress and Coping and Their Effects on Mental Health
  5. Week 3 Discussion 1: What Factors Influence Self-Injurious Behavior?

Week 3 Discussion 1: What Factors Influence Self-Injurious Behavior?

Done: Make forum posts: 1

Value: 100 points

Due: In an effort to facilitate scholarly discourse, create your initial post by Day 4, and reply to at least two of your classmates, on two separate days, by Day 7.

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the question below.

Initial Post

Review the Self-Harm website.

Watch the videos:

5 Not Obvious Signs of Self Harm (4:16 minutes)

5 Not Obvious Signs of Self Harm Video Transcript

Self Harm: What is it About? (12:00 minutes)

Self Harm: What is it About? Video Transcript

Self-injurious behavior is a manifestation of maladaptive coping.

  • Discuss some biological, social, and psychological causes that may explain why young people engage in self-injurious behaviors.
  • Choose one self-injurious behavior that you would like to learn more about.
  • Discuss what the research says about the etiology or the causative factors for this behavior.
  • What evidence-based treatment modalities have been recognized as helpful in managing these behaviors?


Reply to at least two of your classmates. In your reply posts, discuss the treatment modalities in your peers’ post in relation to the treatment modality that you identified in your initial post. Are they similar or different? Reflect on whether or not stigma affects healthcare professionals’ attitudes toward treatment for this type of self-injurious behavior.

Pick out an idea from your peers’ initial post that you find most interesting and tell how you will use this information in practice.

Please refer to the Discussion Board Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.  





Re: Week 3 Discussion 1: What Factors Influence Self-Injurious Behavior?

by Whitney Poppell – Sunday, 14 May 2023, 6:53 PM


The purpose of this discussion is to explore self-injurious behavior among young people. Self-injurious behavior is a broad range of behaviors in which a person causes deliberate harm to their body without intention to die (Son et al., 2021). When young people enact these behaviors, they do so in order to feel better (Yearwood et al., 2012). Self-injurious behaviors include acts like cutting, hitting oneself, skin picking and scratching, biting self, and burning self (Son et al., 2021). For this discussion post, self-injurious behavior will also be referred to as NSSI, which means non-suicidal self-injury. These behaviors often begin during early adolescent years, around age 12-14 (Son et al., 2021). There are biological, social, and psychological factors that can lead to self-injurious behaviors. A biological risk factor for NSSI is the female gender because studies have shown that female adolescents are more likely to partake in self-injurious behaviors in comparison to their male counterparts (Wang et al, 2022). Females tend to engage in NSSI for emotional regulation and self-control (Wang et al., 2022). Social factors that lead to NSSI include a history of being bullied, social media influence, and social contagion or others engaging in NSSI (Yearwood et al., 2012).  Poor family and poor peer relationships can lead to NSSI (Rahman et al., 2021). Psychological risk factors for NSSI include chronic feelings of hopelessness and experiencing adverse childhood experiences (Yearwood et al., 2012). Psychiatric disorders that are associated with NSSI include mood disorders, borderline personality disorder, and depression (Hetrick et al., 2020).

A self-injurious behavior that I would like to learn more about is cutting. I currently work in a pediatric facility and often see adolescents with healed or active cutting marks to their arms. Cutting, or using a sharp object to carve into one’s skin, can be considered a moderate level of self-harm (Son et al., 2021). Many studies point to adverse childhood experiences (ACEs) being a root cause for cutting (Son et al., 2021). ACEs or childhood trauma is linked to neurohormonal changes in the brain and dysregulated stress responses (Wheeler, 2020). ACEs are linked to structural brain changes to the HPA axis, which is responsible for cortisol, the stress hormone (Son et al., 2021). Those who have experienced trauma may use cutting to help relieve tension (Wheeler, 2020). This is believed to be caused by a decrease in cortisol levels secondary to increased stress (Yearwood et al., 2012). Cortisol levels are initially increased and lead to cutting, which then decreases the person’s arousal level, causing a decrease in cortisol and an increase in endorphins (Yearwood et al., 2012). This leads to a calm, peaceful state after the act of cutting and can explain why an individual may partake in repetitive cutting behavior (Wang et al., 2022).

Treatment for NSSI is mainly focused on psychosocial interventions. Dialectical behavior therapy for adolescents (DBT-A) has been proven to successfully treat NSSI (Bettis et al., 2020). DBT-A targets emotional and behavioral dysregulation and focuses on interpersonal effectiveness (Bettis et al., 2020). This is done through focus on cognitive/behavioral, mindfulness, and acceptance principles and involves the participation of both the adolescent and their caretaker (Bettis et al., 2020). DBT-A treatment decreases self-injurious behavior by increasing the adolescent’s ability to manage and regulate negative emotions through healthy coping skills and behaviors (Bettis et al., 2020). Another treatment modality that I found interesting was Mentalization-Based Treatment for Adolescents (MBT-A). This is a psychotherapy approach that I was not familiar with. MBT-A targets NSSI by teaching mentalization skills, or the ability to understand behaviors as they relate to thoughts and feelings (Bettis et al., 2020). MBT-A has shown efficacy in reducing self-injurious behaviors in adolescents (Bettis et al., 2020).


Bettis, A., Liu, R., Walsh, B., & Klonsky, E. (2020). Treatments for self-injurious thoughts and behaviors in youth: Progress and challenges. Evidence-Based Practice in Child and Adolescent Mental Health, 5(3), 354-364.

Hetrick, S., Subasinghe, A., Anglin, K., Hart, L., Morgan, A., & Robinson, J. (2020). Understanding the needs of young people who engage in self-harm: a qualitative investigation. Frontiers in Psychology, 10.

Rahman, F., Webb, R., Wittkowski, A. (2021). Risk factors for self-harm repetition in adolescents: A systematic review. Clinical Psychology Review, 88.

Son, Y., Kim, S., & Lee, J. (2021). Self-injurious behavior in community youth. International Journal of Environmental Research and Public Health, 18(4), 1955.

Wang, Y., Li, X., Ng, C., Xu, D., Hu, S., & Yuan, T. (2022). Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis. eClinicalMedicine: The Lancet, 46.

Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse (Locomotive Portfolios) (3rd ed.). Springer.

Yearwood, E., Pearson, G. S., & Newland, J. A. (2012). Child and adolescent behavioral health. Wiley-Blackwell. 

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