The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists both suicidal behavior disorder and nonsuicidal self-injury as conditions for further study. The essential feature of suicidal behavior disorder is that the individual has at least some intent to die. The essential feature of nonsuicidal self-harm is that the individual repeatedly inflicts superficial injuries to the body. Controversy continues to exist about whether the proposed disorders are part of a continuum of self-harm or distinct categories. Suicidal behavior is growing fastest in pre- and early adolescent girls. Nonsuicidal self-injury should be distinguished from stereotypic self-injury. Screeners can help to identify students who need a thorough assessment. Full assessments should utilize a crisis team. Recommendations are made for each tier using a multitiered system of supports framework. A case example illustrates school-based intervention for nonsuicidal self-injury.
Keywords: adolescents, assessment, cognitive-behavioral therapy, Columbia Suicide Severity Rating Scale (C-SSRS), contagion, emotional regulation, family therapy, interpersonal therapy, nonsuicidal self-injury, suicide
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