Reframing adolescent self-harm as a functional continuum
Bibliographic Data
| ID | 15527734 |
|---|---|
| Authors | Qian-Nan Ruan (Wenzhou City People's Hospital), Wen-Jing Yan, Wen‐jing Yan (0000-0001-6413-2414, Wenzhou Medical University, corresponding author) |
| Year | 2025 |
| Volume | 16 |
| Pages | 1724449-1724449 |
| Publication date | 2025-12-02 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Psychiatry (JOURNAL) |
| Journal identifiers | ISSN: 1664-0640 • E-ISSN: 1664-0640 |
| Publisher | Frontiers Media (PUBLISHER • CH) |
| DOI | 10.3389/fpsyt.2025.1724449 |
| PMID | 41409333 |
| OpenAlex | W4417497846 |
| Language | EN |
| Citations received | 1 |
| References cited | 31 |
The clinical and research fields have long relied on a dichotomous classification of adolescent self-harm, rigidly separating non-suicidal self-injury (NSSI) from suicide attempts (SA) based on intent. While operationally convenient for acute risk assessment, this framework oversimplifies the complex clinical reality of mixed and fluctuating intent and obscures the profound developmental and functional links between these behaviors. This perspective article argues for a conceptual shift away from this dichotomy toward a functional continuum model (FCM). The FCM posits that all self-harm behaviors exist on a multidimensional spectrum and are selected from a shared pool of psychological functions-primarily to regulate overwhelming emotional pain (psychache). We reinterpret epidemiological, psychological, and neurobiological evidence to demonstrate that NSSI and SA are not disparate phenomena but rather evolving expressions of the same underlying pathological process. Specifically, NSSI can act as a behavioral training ground that builds the acquired capability for suicide. This model reframes clinical intervention, shifting the focus from mere behavioral cessation to functional rehabilitation-equipping adolescents with adaptive skills to replace the maladaptive functions of self-harm. Finally, we outline future directions for research, including the use of ecological momentary assessment (EMA) and the development of function-specific assessment tools to translate this model into a more precise, dynamic, and compassionate standard of care
Cognition · Cognitive reframing · Focus (optics · Functional analysis · Functional approach · Perspective (graphical · Relational frame theory · Mental Health Research Topics · Personality Disorders and Psychopathology · Suicide and Self-Harm Studies
Self-Injury
Assessing the Functions of Non-suicidal Self-injury
A Functional Approach to the Assessment of Self-Mutilative Behavior.
Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm
The longitudinal course of non-suicidal self-injury and deliberate self-harm
The interpersonal theory of suicide.
Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures
Self-Injury in Japanese Manga
The Self-perpetuating Cycle of Shame and Self-injury
A meta-analysis on the affect regulation function of real-time self-injurious thoughts and behaviours
| Citations per year | 1 |
|---|---|
| Citation span | 2026 - 2026 (1) |
| Highly cited | No |