Selbstverletzendes Verhalten und Suizidversuche: Fundierung der Differenzialdiagnostik

Zusammenfassung

Drei Kriterien zur Differenzialdiagnostik von selbstverletzendem Verhalten und Suizidversuchen sollen anhand neuerer empirischer Studien auf ihre Gültigkeit geprüft werden. Untersucht werden die Kriterien zu Motiven (Funktionen), Selbstverletzungsmethoden (Verletzungsschwere) sowie Auftretenshäufigkeit und Episodenanzahl über die Lebenszeit. Die Literaturanalyse ergab, dass nur wenige Studien einen direkten Vergleich zwischen selbstverletzendem Verhalten und Suizidversuchen thematisieren. Daher wurden zusätzlich Studien hinzugezogen, die Unterschiede in Zusammenhang mit der Ausprägung der Suizidabsicht fokussieren. Die empirischen Befunde zu Motiven und Funktionen, Methoden und Verletzungsschwere sowie zu Auftretenshäufigkeit und Episodenanzahl über die Lebenszeit wurden mit den bestehenden Kriterien abgeglichen. Bis auf die Lebenszeithäufigkeit differenzieren alle Merkmale entsprechend den Vorgaben. Im Falle der Motive ermöglicht jedoch erst eine differenzierte Betrachtung eine Unterscheidung zwischen selbstverletzendem Verhalten und Suizidversuchen. Zur Optimierung der Differenzialdiagnostik sind die Kriterien daher geringfügig zu modifizieren. Aufgrund der phänomenologischen Überlappungen beider Selbstschädigungstypen scheint ein dimensionales Vorgehen hilfreich.

Abstract

Three criteria for differential diagnosis of non-suicidal self-injury and suicide attempts were validated by means of more recent empirical studies. Criteria concerning motives (functions), methods of self-injury (medical severity), lifetime frequency and lifetime number of episodes were investigated. Literature research showed only a few studies concentrated on a direct comparison of non-suicidal self-injury and suicide attempts. Therefore, studies examing the relationship of suicide intent to the relevant features, are considered, too. Empirical results concerning motives (functions), methods (medical severity), lifetime frequency and number of episodes were compared to the three criteria. Except for lifetime frequency, studies support the criteria. However, in the case of motives, a more differentiated examination is needed to distinguish between non-suicidal self-injury and suicide attempts. To optimize the assessment, guidelines should be slightly modified. Because of the phenomenological overlap of non-suicidal self-injury and suicide attempts, a dimensional assessment can be helpful.

Schlüsselwörter

selbstverletzendes Verhalten - Suizidversuch - Differenzialdiagnostik

Key words

non-suicidal self-injury - suicide attempt - differential diagnosis

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