Defining and refining self-harm: A historical perspective on nonsuicidal self-injury

Cara Angelotta*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalJournal of Nervous and Mental Disease
Issue number2
StatePublished - Feb 6 2015


  • Cutting
  • DSM
  • nonsuicidal self-injury
  • psychiatric diagnosis
  • self-harm

ASJC Scopus subject areas

  • Psychiatry and Mental health


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