Self-injurious behavior and adolescence: a review of predisposing factors, preventive and therapeutic strategies

Autori

DOI:

https://doi.org/10.12957/sustinere.2025.74124

Parole chiave:

Self-injurious behavior, Self-mutilation, Therapies, Adolescents.

Abstract

With the aim of describing self-injurious behavior among adolescents, including predisposing factors, strategies for health promotion and prevention of this behavior, as well as for its treatment, a narrative review was developed based on the criteria of the Scale for the Assessment of Narrative Review Articles. Searches were carried out in the PubMed, Virtual Health Library, Scientific Electronic Library Online, CAPES, and Google Scholar databases with a time frame from 2018 to 2023, and the primary descriptors used were “Self-Injurious Behavior”, “Self Mutilation”, “Adolescent”, “Causality”, “Risk factors”, “Suicide”, “Suicidal Ideation”, “Health Promotion”, “Primary Prevention”, “Secondary Prevention”, “Tertiary Prevention”, “Therapeutic ” and “Self-harm Behavior”. The selected articles were categorized into 1. Predisposing factors for self-injury, 2. Preventive strategies for self-injury, and 3. Therapeutic strategies for self-injury. It was evident that adolescence is marked by challenges, vulnerability, and brain immaturity, which makes these subjects prone to self-harm behaviors. Factors such as family conflicts, psychological disorders, childhood abuse, prejudice and discrimination, and being female increase this propensity. Strengthening family ties, teacher-student approximation, and health service-user stand out as preventive strategies for self-injury. Treatment should include early identification and intervention, with possibilities such as harm reduction and emotional regulation techniques, as well as psychotherapy with Cognitive Behavioral Therapy.

Biografie autore

Gabriela Garcia de Carvalho Laguna, Multidisciplinary Institute in Health at the Federal University of Bahia (UFBA - IMS/CAT)

Physician from Multidisciplinary Institute in Health at the Federal University of Bahia (UFBA - IMS/CAT). Researcher at the Center for Studies and Research in Health (NEPS/UFSB) and at the Bahia Center for Research in Medical Anthropology (CBPAM/UFBA). She served as Scientific and Health Policy Coordinator of the National Executive Board of Medical Students (DENEM). She worked as research and extension coordinator at the Fabrício Freire Academic Center (CAFF, IMS/UFBA). She was a PROEXT scholarship holder of the extension project Body Subject: Art in Health Promotion, in which she conducted artistic workshops at CAPS II in Vitória da Conquista. Founder and director of research at the Academic League of Pediatrics (LIPED - IMS/UFBA); teaching director of the Piauiense Mental Health League (LASMENPI/UFDPar). She served as research director of the Academic League of Psychiatry and Mental Health (LIAPS/UESB) and as extension director of the Academic League of Neurosciences (NeuroLiga - UFBA-IMS/CAT). She was a monitor of Principles of Psychopharmacology. She carried out internships in Psychiatry at the Catholic University of Brasília (UCB) and linked to the writing and dissemination of scientific texts (UFBA-IMS / CAT), in which she published mainly articles related to psychiatry and mental health. She participated in extension projects related to mental health: telemonitoring at CAPS-IA, related to the promotion and dissemination of mental health interventions through social media and conversation circles about literary affectations. She served as a volunteer at the Life Valorization Center (CVV) during the COVID-19 pandemic. She has experience in the areas of public health, mental health, neurosciences, health education, and medical anthropology.

Letícia Defensor da Silva Santos, Multidisciplinary Institute in Health at the Federal University of Bahia (UFBA - IMS/CAT)

Psychology from Federal University of Bahia (UFBA - IMS/CAT). She works in Early Intervention with children with ASD and other neurodevelopmental disorders, based on the ESDM (Early Start Denver Model), in which she has begun international training. She conducts behavioral and diagnostic psychological assessments in children and adolescents and is currently pursuing a postgraduate degree in Neuropsychology. She has professional training in the Management of Aggressive Behaviors, IISCA/SBT, and Professional Crisis Management (PCM 2P). During her undergraduate studies, she completed internships in child behavioral clinics, focusing on assessment and intervention for neurodevelopmental disorders and specific learning difficulties. Since 2022, she has worked as a therapeutic companion (AT) for children with ASD, grounded in ABA science, specifically using ESDM. She provided training for a multidisciplinary team at the Child and Adolescent Psychosocial Care Center (CAPSia) in Vitória da Conquista, focusing on child development, diagnosis, and intervention in ADHD and ASD. She was also a member of the Academic Neuroscience League (NeuroLiga – UFBA-IMS/CAT).

Luana Leal Gonzaga, Multidisciplinary Institute in Health at the Federal University of Bahia (UFBA - IMS/CAT)

Medical student at the Federal University of Bahia - Campus Anísio Teixeira. Local Director of the Human Rights and Peace Committee of IFMSA-Brasil UFBA-CAT (2023-2024). People Management Director (2023-2024) and Founding Member of Pediatric League - LIPED-IMS. Director of Media and Marketing of the Academic League of Neurosciences - IMS/UFBA (2022-2023). Member of the extension project SerTão Ciência Podcast. Volunteer Monitor of the Sankofa Program for people with educational needs.

Sara Emanuelle dos Santos Neves, Multidisciplinary Institute in Health at the Federal University of Bahia (UFBA - IMS/CAT)

Bachelor of Health from the Federal University of Bahia (UFBA). Medical student at the Multidisciplinary Institute in Health at the Federal University of Bahia (UFBA - IMS/CAT). Research and extension coordinator at the Fabrício Freire Academic Center (CAFF, IMS/UFBA). PIBIC scholarship holder of the project Evaluation of the effects of continuous low-intensity exercise on the brain parameters of Wistar rats submitted to the application of cisplatin. She is a member of the Academic League of Neurosciences (NeuroLiga-UFBA-IMS / CAT). She acted as a school therapeutic companion (A.T.E.) of children with Autistic Spectrum Disorder (ASD) in the research and extension group entitled Investigations in Cultural Psychology: Culture, Language, Transitions and Developmental Trajectories (CULTS / UFBA). She interned in the coordination of hospital care at the Bahia State Health Department (SESAB).

Katiene Rodrigues Menezes De Azevedo, Multidisciplinary Institute in Health at the Federal University of Bahia (UFBA - IMS/CAT)

Psychiatrist. Lecturer in the medical course at the Multidisciplinary Institute in Health at the Federal University of Bahia (UFBA - IMS/CAT). Master in Health Psychology by IMS/CAT-UFBA. Preceptor in the medical residency program in Psychiatry in Vitória da Conquista. Specialization in Child and Adolescent Psychiatry by CURSOMED and in Neurosciences and Behavior by PUCRS. Researcher at the Bahia Center for Research in Medical Anthropology (CBPAM/UFBA). She worked as a psychiatrist at CAPSi in Vitória da Conquista / BA from 2016 to 2022, during which time she also coordinated the medical residency program in Psychiatry in Vitória da Conquista.

Riferimenti bibliografici

ALENCAR, C. G. V. Por que me comporto assim transformações cerebrais na adolescência. FATEC, 2009.

AMERICAN PSYCHIATRIC ASSOCIATION. Manual Diagnostico e Estatístico de Transtornos Mentais. ARTMED EDITORA LTDA, 2014.

ASARNOW, J. R.; BAI, S.; BABEVA, K. N.; ADRIAN, M.; BERK, M. S.; ASARNOW, L. D.; SENTURK, D.; LINEHAN, M. M.; MCCAULEY, E. Sleep in youth with repeated self-harm and high suicidality: Does sleep predict self-harm risk? Suicide & life-threatening behavior, v. 50, n. 6, p. 1189–1197, Dec. 2020. doi: 10.1111/sltb.12658

BAETHGE, C.; GOLDBACK-WOOD, S.; MERTENS, S. SANRA - a scale for the quality assessment of narrative review articles. Research Integrity and Peer Review, 2019. https://doi.org/10.1186/s41073-019-0064-8

BRASIL. MINISTÉRIO DA SAÚDE. Lei no 13.819, de 26 de Abril de 2019. 2019. Available in: https://www.gov.br/saude/pt-br/acesso-a-informacao/conselhos-e-comites/cgpnpas/atos-normativos/lei-no-13-819-de-26-de-abril-de-2019.pdf/view. Accessed on: February 3, 2023.

BRITO, M. D. L. DE S.; SILVA JÚNIOR, F. J. G. DA; COSTA, A. P. C.; SALES, J. C. E. S.; GONÇALVES, A. M. DE S.; MONTEIRO, C. F. DE S. Comportamento suicida e estratégias de prevenção sob a ótica de professores. Escola Anna Nery, v. 24, n. 4, July 3, 2020.

BYRNE, S.J., BELLAIRS-WALSH, I., RICE, S. M., BENDALL, S., LAMBLIN, M., BOUBIS, E., MCGREGOR, B., O'KEEFER, M., ROBINSON, J. A Qualitative Account of Young People's Experiences Seeking Care from Emergency Departments for Self-Harm. Int J Environ Res Public Health, n. 18, v. 6, March 2021. doi: 10.3390/ijerph18062892

CALVO, N.; GARCÍA-GONZÁLES, S.; PÉREZ-GALBORRO, C.; REGALES-PECO, C.; LUGO-MARIN, J.; RAMOS-QUIROGA, J. A.; FERRER, M. Psychotherapeutic interventions specifically developed for NSSI in adolescence: A systematic review. European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology, v. 58, p. 86–98, May 1, 2022. doi: 10.1016/j.euroneuro.2022.02.009

CARMO, J. D. S.; SILVEIRA, P. H. F. S.; VIGNARDI, R. G.; CANICOBA, G. S.; MOTA, A. C. M. F.; MIZIARA, C. S. M. G.; MIZIARA, I. D. Autolesão não suicida na adolescência como fator de predisposição ao suicídio. Saúde Ética & Justiça, v. 25, n. 1, p. 3–9, July 3, 2020. https://doi.org/10.11606/issn.2317-2770.v25i1p3-9

COIMBRA, L. R. R.; NOAKES, A. Uma revisão sistemática sobre as atitudes dos profissionais de saúde face à automutilação em crianças e jovens e o seu impacto na prestação de cuidados. Journal of Child Health Care, n. 26, v. 2, p. 290-306, 2022. doi: 10.1177/13674935211014405

CURTIS, S.; THORN, P.; MCROBERTS, A.; HETRICK, S.; RICE, S.; ROBINSON, J. Caring for Young People Who Self-Harm: A Review of Perspectives from Families and Young People. International journal of environmental research and public health, v. 15, n. 5, May 10, 2018. doi: 10.3390/ijerph15050950

D’ANCI, K. E.; UHL, S.; GIRADI, G.; MARTIN, C. Treatments for the Prevention and Management of Suicide: A Systematic Review. Annals of internal medicine, v. 171, n. 5, p. 334–342, Sept. 3, 2019. doi: 10.7326/M19-0869

SILVA, M. G.; PEREIRA, A. C. T.; ROQUES DAUZACKER, R. A.; MACIEL GARCIA, E. A.; FONSECA, W.; BERNAL, J.; SANTOS, V. S.; LUZI, S. L. Conduta de Autolesão não Suicida em Adolescentes. Saúde em Redes, v. 8, n. sup1, p. 261–272, July 8, 2022. https://doi.org/10.18310/2446-4813.2022v8nsup1p261-272

DAUKANTAITĖ, D.; LUNDH, L.-G.; WÅNGBY-LUNDH, M.; CLARÉUS, B.; BJÄREHED, J.; ZHOU, Y.; LILJEDAHL, S. I. What happens to young adults who have engaged in self-injurious behavior as adolescents? A 10-year follow-up. European child & adolescent psychiatry, v. 30, n. 3, p. 475–492, April 21, 2020. doi: 10.1007/s00787-020-01533-4

DAVIES, J.; PITMAN, A.; BAMBER, V.; BILLINGS, J.; ROWE, S. Young peoples’ perspectives on the role of harm reduction techniques in the management of their self-harm: A qualitative study. Archives of Suicide Research, 2020. https://doi.org/10.1080/13811118.2020.1823916.

DENISSOFF, A.; LEVOLA, J.; NIEMELÄ, S.; MUSTONEN, A. Cannabis, and Intentional Self-injury: a Narrative Review. Current Addiction Reports, v. 9, n. 4, p. 598–607, Nov. 4, 2022. Available in: https://link.springer.com/article/10.1007/s40429-022-00453-4. Accessed on: Feb. 27, 2023

EGGART, V.; CORDIER, S.; HASAN, A.; WAGNER, E. Psychotropic drugs for the treatment of non-suicidal self-injury in children and adolescents: a systematic review and meta-analysis. European archives of psychiatry and clinical neuroscience, v. 272, n. 8, p. 1559–1568, Feb. 16, 2022. doi: 10.1007/s00406-022-01385-w

ESCOBAR, A. M. P. R.; ARRUDA, M. F. A.; SOBRINHO, J. E. L. Estratégias de prevenção do suicídio e da autolesão voltadas para adolescentes em ambientes escolares: uma revisão integrativa da literatura. Research, Society and Development, 2022. http://dx.doi.org/10.33448/rsd-v11i3.26157

FARBSTEIN, D. et al. Risk and protective factors for self-harm and suicide in children and adolescents: a systematic review and meta-analysis protocol. BMJ open, v. 12, n. 11, p. e058297, Nov. 25, 2022. Available in: https://bmjopen.bmj.com/content/12/11/e058297. Accessed on: Feb. 27, 2023.

FONSECA, P. H. N.; SILVA, A. C.; ARAÚJO, L. M. C.; BOTTI, N. C. L. Autolesão sem intenção suicida entre adolescentes. Arquivos brasileiros de psicologia, v. 70, n. 3, p. 246–258, 2018. Available in: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1809-52672018000300017. Accessed on: Fev. 27, 2023.

GABRIEL, I. M.; COSTA, L. C. R.; CAMPEIZ, A. B.; SALIM, N. R.; SILVA, M. A. I.; CARLOS, D. M. Autolesão não suicida entre adolescentes: significados para profissionais da educação e da Atenção Básica à Saúde. Escola Anna Nery, v. 24, n. 4, 13 July 2020. Available in: https://doi.org/10.1590/2177-9465-EAN-2020-0050. Accessed on: Feb. 27, 2023.

GONÇALVES, M. et al. Comportamentos Autolesivos Sem Intenção Suicida em Adolescentes. [s.l: s.n.]. Available in: https://repositorio.ul.pt/bitstream/10451/52639/1/MariaCGomes.pdf. Accessed on: Feb. 26, 2023.

HERCULANO-HOUZEL, S. O cérebro adolescente - A neurociência da transformação da criança em adulto. Objetiva, 2005.

HUANG, Y.-H.; LIU, H.-C.; SUN, F.-J.; LIU, S.-I. Predictors of repeated adolescent self-harm: The display of multiple variables and mediators in a 2-year study. Journal of the Formosan Medical Association = Taiwan yi zhi, v. 121, n. 12, p. 2584–2592, Dec. 2022. https://doi.org/10.1016/j.jfma.2022.08.019

HUGHES, N. D.; LOCOCK, L.; SIMKIN, S.; STEWART, A.; FERREY, A. E.; GUNNELL, D.; KAPUR, N.; HAWTON, K. Making Sense of an Unknown Terrain: How Parents Understand Self-Harm in Young People. Qualitative health research, v. 27, n. 2, p. 215–225, Jan. 2017. doi: 10.1177/1049732315603032

IYENGAR, U.; SNOWDEN, N.; ASARNOW, J. R.; MORAN, P.; TRANAH, T.; OUGRIN, D. A Further Look at Therapeutic Interventions for Suicide Attempts and Self-Harm in Adolescents: An Updated Systematic Review of Randomized Controlled Trials. Frontiers in psychiatry / Frontiers Research Foundation, v. 9, 2018. doi: 10.3389/fpsyt.2018.00583

KAESS, M. et al. Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study. The Journal of adolescent health: official publication of the Society for Adolescent Medicine, v. 66, n. 2, p. 195–201, Feb. 2020. doi: 10.1016/j.jadohealth.2019.08.018

KAMAZAKI, D. F.; DIAS, A. C. G. Intervenções para autolesão não suicida: uma revisão sistemática da literatura. Contextos Clínicos, v. 14, n. 1, p. 228–251, 2021. https://doi.org/10.4013/ctc.2021.141.11

KANDSPERGER, S.; SCHLEICHER, D.; ECKER, A.; KECK, F.; BENTHEIMER, S.; BRUNNER, R.; JARVERS, I. Emotional Reactivity in Adolescents With Non-suicidal Self-injury and Its Predictors: A Longitudinal Study. Frontiers in psychiatry / Frontiers Research Foundation, v. 13, 2022. doi: 10.3389/fpsyt.2022.902964

KELLY, Y.; ZILANAWALA, A.; BOOKER, C.; SACKER, A. Social Media Use and Adolescent Mental Health: Findings From the UK Millennium Cohort Study. EClinicalMedicine, v. 6, p. 59–68, Dec. 2018. doi: 10.1016/j.eclinm.2018.12.005

LIANG, K.; ZHAO, L.; LEI, Y.; ZOU, K.; JI, S.; WANG, R.; HUANG, X. Nonsuicidal self-injury behavior in a city of China and its association with family environment, media use and psychopathology. Comprehensive psychiatry, v. 115, p. 152311, May 2022. doi: 10.1016/j.comppsych.2022.152311

MeSH - NCBI. Disponível em: https://www.ncbi.nlm.nih.gov/mesh/. Accessed on: Jan. 16, 2023.

MOREIRA, É. S.; VALE, R. R. M.; CAIXETA, C. C.; TEIXEIRA, R. A. G. Automutilação em adolescentes: revisão integrativa da literatura. Ciência & Saúde Coletiva, v. 25, n. 10, p. 3945–3954, Sept. 28, 2020. https://doi.org/10.1590/1413-812320202510.31362018

NAZ, A.; NAUREEN, A.; KIRAN, T.; HUSAIN, O.; MINHAS, A.; RAZZAQUE, B.; TOFIQUE, S.; HUSAIN, N.; FURBER, C.; CHAUDHRY, N. Exploring Lived Experiences of Adolescents Presenting with Self-Harm and Their Views about Suicide Prevention Strategies: A Qualitative Approach. International journal of environmental research and public health, v. 18, n. 9, April 28, 2021. doi: 10.3390/ijerph18094694

NEVES, C. C. S.; PEREIRA, A. P. C.; PEREIRA, C. A. S. Estratégias de prevenção do suicídio na escola para adolescentes: uma revisão de literatura na base medline. Research, Society and Development, v. 9, n. 7, p. e300973945, May 12, 2020. DOI:10.33448/rsd-v9i7.3945

PAPALIA, D. E.; FELDMAN, R. D. Desenvolvimento Humano. 2013.

POUDEL, A.; LAMICHHANE, A.; MAGAR, K. R.; KHANAL, G. P. Non suicidal self injury and suicidal behavior among adolescents: co-occurrence and associated risk factors. BMC psychiatry, v. 22, n. 1, p. 96, Feb. 9, 2022. Available in: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-03763-z. Accessed on: Feb. 27, 2023.

ROTHER, E. T. Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, v. 20, n. 2, p. v–vi, June 2007. https://doi.org/10.1590/S0103-21002007000200001

SANTO, M. A. DA S.; BEDIN, L. M.; DELL’AGLIO, D. D. Self-injurious behavior and factors related to suicidal intent among adolescents: a documentary study. Psico-USF, v. 27, n. 2, p. 357–368, Sept. 26, 2022. https://doi.org/10.1590/1413-82712022270212

SERRANO, C. C.; FAJARDO-DOLCI, G. Suicide prevention and suicidal behavior. Gaceta Médica de México, v. 157, n. 5, 2021. doi: 10.24875/GMM.M21000611

SHOREY, S.; NG, E. D.; WONG, C. H. J. Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis. The British journal of clinical psychology / the British Psychological Society, v. 61, n. 2, p. 287–305, June 2022. https://doi.org/10.1111/bjc.12333

TANG, J.; LI, G.; CHEN, B.; HUANG, Z.; ZHANG, Y.; CHANG, H.; WU, C.; MA, X.; WANG, J.; YU, Y. Prevalence of and risk factors for non-suicidal self-injury in rural China: Results from a nationwide survey in China. Journal of affective disorders, v. 226, p. 188–195, Jan. 15, 2018. doi: 10.1016/j.jad.2017.09.051

TRINCO, M. E., SANTOS, J. C. Comportamento autolesivo na adolescência e experiência da família: Revisão da literatura. Revista Portuguesa de Enfermagem de Saúde Mental, Porto, n. 25, p. 131-146, jun. 2021. Available in: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1647-21602021000100131&lng=pt&nrm=iso. Accessed on: Feb. 27, 2023.

WITT, K. G.; HETRICK, S. E.; RAJARAM, G.; HAZELL, P.; TAYLOR SALISBURY, T. L.; TOWNSEND, E.; HAWTON, K. Interventions for self‐harm in children and adolescents. Cochrane database of systematic reviews, v. 2021, n. 3, 2021. doi: 10.1002/14651858.CD012013

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2026-01-05

Come citare

Laguna, G. G. de C., Santos, L. D. da S., Gonzaga, L. L., Neves, S. E. dos S., & De Azevedo, K. R. M. (2026). Self-injurious behavior and adolescence: a review of predisposing factors, preventive and therapeutic strategies. Revista Sustinere, 13(2), 634–655. https://doi.org/10.12957/sustinere.2025.74124

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