We have received an inquiry from one of our members regarding the semantic difference between 248062006 | Self-injurious behavior (finding) | and 1157096002 |Self destructive behavior (finding)| (which was just added in 2021). Going through the literature, these are sometimes conflated and sometimes treated as separate. Can the MBH group give some insight? It appears that ICD and DSM do not use the notion of 1157096002 |Self destructive behavior (finding)|
Piper Allyn Ranallo
Tagging Laura Fochtmann, Michael First Uma Vaidyanathan, Janna Hastings for their thoughts.
My interpretation would be that 'self destructive behaviour' is intended to be a broader term than 'self-injurious behaviour' -- for example, encompassing behaviours that are harmful to the self in ways other than through inflicting physical injury on the body (e.g. risky sexual behaviour?). By contrast, all the children of 'self-injurious behaviour' reflect physical bodily harm.
My interpretation would be similar to that of Janna Hastings, that it's a broader term that would include but not require actual self injury. Since it was just added in 2021, do we know who had it added and why?
Thank you for your thoughts. This question had been raised by me. I had the same interpretation as Janna Hastings and Laura Fochtmann, but I was confused by that it only has one child in SNOMED: 248062006 |Self-injurious behavior (finding)|, which has only physical self-injurous behaviors as children. Is the term 'Self destructive behavior' something you use in your practice? If not, I think we might leave it untranslated in the Dutch edition to avoid different interpretations. Thank you in advance!
Inge Soons (medical terminologist of the SNOMED NRC in the Netherlands)
Piper Allyn Ranallo
Inge Soons, I think to Laura Fochtmann's previous point, it may be worth contacting the requestor of the concept 1157096002 |Self destructive behavior (finding)| (which was just added in 2021) to learn more about their Use Case. Would that be helpful?
Elaine Wooler, do you have a way of getting this information?
Yes, that would be very helpful, thank you!
This concept was added following a request from the nursing CRG for a new concept - 1157028009 |No self destructive behavior (situation)|
Self-destructive behaviour had been a synonym on the concept 248062006 |Self-injurious behavior (finding)| it was discussed and agreed (with supporting research) that this was not synonymous and that these were different things with self-destructive behaviour being a broader concept therefore the synonym inactivated and a new concept 1157096002 |Self destructive behavior (finding)| created which was then used to model the situation concept.
Thank you Elaine, do you possibly have that literature available to understand what the differences are?
This should help:
American Psychological Association Dictionary
Deliberate self-harm the intentional, direct destruction of body tissue (most commonly by cutting, burning, scratching, self-hitting, self-biting, and head banging) without conscious suicidal intent but resulting in injury severe enough for tissue damage to occur. Although, by definition, DSH is distinguished from suicidal behaviors involving an intent to die, it is nonetheless potentially life-threatening. Typically associated with borderline personality disorder, it has also been found to occur at high rates among nonclinical populations of adolescents. It is seen as well in individuals with intellectual and developmental disabilities, in whom it is usually known by its older synonym self-injurious behavior. Also called self-injury.
Self-destructiveness - actions by an individual that are damaging and not in his or her best interests. The individual may not be aware of the damaging influence of the actions or may on some level wish for the resulting damage. The behavior may be repetitive and resistant to treatment, sometimes leading to suicide attempts. —self-destructive adj.
Also as both Laura and Janna describe above.
Great, very clear! Many thanks.
Agree with the above, that it looks like "deliberate self harm" is primarily about physical harm, whereas "self destructive behavior" can also include behaviours with social consequences.
Also, some behaviours may not be necessarily deliberate..
So the current arrangement of these concepts in SNOMED is consistent with this.